Now, we know definitely that Leptin controls all energy production by regulating all the hormones in the body. But, do you wonder what happens when that regulation goes awry in the muscles? Well, here is some information about one part of how Leptin works to keep us fit when your body is sensitive to it.

When Leptin was discovered in 1994, no one really had a clue as to its many functions. One function that was particularly murky was how the brain controlled peripheral energy utilization and optimized it. It is awfully hard to realize that the hypothalamus (size of a pea) can control the need for fuel of 20 trillion cells in the human body. Well in the last few years, scientists found out about uncoupling proteins (UCP). So far five have been discovered in mammals. The one we will discuss today is UCP3.

This protein, UCP3, allows Leptin to work inside of peripheral cells like the muscle cell. For UCP3 to work optimally, it requires optimal functioning of leptin and thyroid hormone simultaneously. In muscle cells, UCP3 is the dominant UCP in humans. So it is vital to maximizing efficiency in exercise and energy use. In fact, in trained athletes, UCP3 levels will go down in all muscle fibers types because they will become more efficient if the athlete is burning long chain fatty acids. Most athletes, however, do not maximize this effect of proton leak because they use too many carbs to fuel themselves. When UCP3 is maximized LCFA are exported out of the mitochondria and UCP1 burn food electrons as free heat. This changes the cell water in cells. MCT has no effect on UCP3. What UCP3 allows the muscle to do, is to shift out of regular oxidative energy production done at the mitochondria and making energy, in the form of ATP, and into making pure heat without generating ATP. This biochemical action decreases ROS (levee 3) at the mitochondrial level, decreasing cellular stress. And therefore the energy is dissipated mostly as heat. Another protein, UCP1, is dedicated to doing this same action when it is activated 100{a7b724a0454d92c70890dedf5ec22a026af4df067c7b55aa6009b4d34d5da3c6} of the time.

UCP3 functions in this manner as an alternative pathway to deal with excess energy (electrons and protons). This is the reason why you hear people like Gary Taubes and myself, tell people that calories do not matter when you are Leptin sensitive. However, they matter big time to folks who are Leptin resistant, because they cannot utilize these pathways at all. This is the primary pathway in which fat burning occurs peripherally in the human body. If it is not working well, or at all, the excess calories are sent packing to visceral stores or to organ depots that generate their own set of problems when it occurs chronically.

Let us think about what this means for the muscle cell. If you are Anthony Colpo or Robb Wolf, you can burn whatever fuel you receive, because your UCP3 is optimal. The fuel source is usually immaterial when in season, even if the source is high in carbs or high in fats. But let’s say you’re Oprah, and you cannot do this; then the muscle cell has to make a choice. Since her UCP3 is not optimal when fuel is delivered to the muscle it cannot be used quickly and builds up. The cell tries to activate UCP3 to dissipate the excess but it requires Leptin sensitivity and good T3 and T4 function. We know by looking at Oprah that she is not optimal (the mirror test). With exercise Oprah tires quickly and her muscles fatigue faster than someone like Robb’s does. WHY? She cannot utilize the fuel. She spends a lot of time around the blue light in her TV gig. So the excess is sent off to depots, while her muscles are still energy starved and send a signal via the gut to eat more to give the cells fuel. That is precisely what she does over and over again. The problem is that the muscles never get the correct amount of fuel in them to meet demands. (Levee 13)

Chronically, this excess energy is stored in her fat and no matter how much she works out she finds it difficult to lose the weight that she wants. Sound familiar yet? The cure for her is to stop listening to Dr. Oz’s crazy diet recommendations, and instead focus on regaining her Leptin sensitivity to make the muscles burn more efficiently. When her muscles see excess calories consistently, it clogs them with ALE’s from fat and AGE’s from sugars. These are two more levees in The Quilt. Think about what maple syrup looks like if you left it on your countertop for weeks! It becomes concrete-like. This is precisely what happens to muscles in type two diabetic chronically because UCP3 is shot. Moreover, the longer it goes on the worse it gets. That condition then begins to affect the nerves that go to the muscles that innervate them and cause pain and sensory dysfunction. This is how fibromyalgia and peripheral neuropathy develops. It begins with a defect in energy metabolism at the muscle level due to peripheral Leptin resistance.

So when you think about exercise and performance (Cross fit/Wolf) folks one must understand the context your muscles are in when you begin to optimize yourself. This contextual problem is why we have so many competing ideas of how we should advocate exercise for all people. Exercise for Robb et al does not equate with Oprah because their biochemistries are not similar.

Here is the best part: Oprah can become equal to them if she has somebody explain this to her. Dr. Oz certainly has not for over a decade! Her goal is to focus on becoming Leptin sensitive by being required to eat 50 grams of protein at breakfast everyday within 30 minutes of rising, eliminating all snacking especially past 7:30 PM, eating three meals a day and limiting her carb intake below 50 grams per day for about 6 to 8 weeks. In my practice, over the last 5 years, that is about the bell curve I have seen that most patients require regaining their Leptin signaling back. I check Leptin sensitivity by asking a few questions, or by ordering a reverse T3 level. Small amounts of carbohydrates will not knock these processes down. There is a range between 50-150 grams a day based upon the season you find yourself in.

Here are my questions for assessing a patient’s Leptin status:

Do you notice you sweat more and have less muscle fatigue when you exercise now?

Have your carb cravings gone away?

Is your hunger under control now?

And are you waking up more refreshed?

When these questions are all yes, then I push the button and tell them to start exercising more with intensity and duration first using weights but never using aerobics. The reason for weightlifting first, is that it generates less ROS in the muscle at the mitochondrial level, and more importantly that it stimulates the release of growth hormone to fire up muscle activity via the neuroendocrine system. It also more quickly reestablishes the Leptin sensitivity of the furnaces that our muscles contain to burn the fat we want to get rid of. As they improve, more weight comes off and the exercise plan increases. So far this plan has not failed me because it is not based upon my opinion. It is based upon our biochemistry that is 2 million years old! Most of my neurosurgical patients get this treatment before I will operate on them because outcomes are better when the patient is metabolically fit for recovery. If you are a patient who is Leptin resistant, and work too hard too quickly with exercise as you drop weight, the risk is generating too much ROS and depleting your stem cell supply. (Levee 17) The short term effect will be weight loss and a good result, but the long term effect may be faster aging and decrease longevity!

This is where I and many trainers don’t see eye to eye. I don’t recommend conventional wisdom. I rely on the knowledge of electrons and protons within biochemistry as the seasons change. Follow me on Twitter @DrJackKruse.Leave a Comment

335 Comments

This explains sooo much!! My leaden muscles, being exhausted, hurting myself whenever I try to push myself to do more vigorous exercise. I retain fluid in crazy amounts after I've exercised – is this a part of it, too? I can gain 3kg in the days following.

Your breakfast recommendation – do you mean ONLY 50g protein, or a breakfast that includes 50g protein?? (ie, should I add veges and fat?) Paleo has already helped with the cravings and not snacking.

For most overweight paleo's I want them loading up for breakfast. 50-75 gms is routine. This recommendation is not set in stone for those who are not leptin resistant obviously. Seems some of the people at PH needed that context. Four egg omelettes with a serious side of bacon is how I roll my breakfast. On surgery days I make a killer coconut smoothie with raw eggs and coconut milk and heavy cream. You will never be hungry if you eat a breakfast like this. the biochemistry behind this recommendation is why……very detailed but I will post it at some point if people are interested.

The reason I advocate this Jac is that recent study out of the University of Missouri was done with teenage girls and protein in the morning. They used functional MRI to validate the work which is a first. The results confirm what I always knew from biochemistry. Eating protein as soon as you rise control hunger and lowers AM cortisol very quickly. Both huge factors for health. If your not hungry you wont over eat and get fat and develop the inflammation that causes disease. Cortisol effect is huge too. Be sure to read my Hormone 101 blog of why it is critical to keep your cortisol low. The girls ate no breakfast, 18 grams of protein and 50 grams of protein. Then they showed the girls a picture of food before lunch. The low protein girls (no protein and 18 grams groups) hypothalamus lit up like crazy on the functional MRI while those who ate 50 grams of protein functional MRI had no areas light up. questionaires also were used with the girls and the low protein girls all were hungry while the girls who ate 50 grams of protein were not. This proves the biochemistry on a neuro-anatomic level. That is why I tell people to eat a ton of protein at breakfast.

Initially with circadian disruption your cortisol is elevated acutely and with chronicity of the deficit it drops as the circadian disruption develops to flat line or even reverse. This refers to the initial reduction once you become aware of the problem. When cortisol drops due a long term artificial light exposure and lack of normal AM sunlight (UV and IR) When UV sunlight is missing venous O2 tension lower and we develop a pseudohypoxia on the skin and this is transmitted to the vessels below the basal layers of the skin. What does pseudohypoxia mean to our hormone panel? The cost of a high aerobic capacity (due to human mitochondrial density) is low fertility and this is why cortisol lowers chronically over time. It is also why Vitamin D3 and the sex steroid hormones lower. This is why the pregnenolone steal syndrome exists. The decision to continue to make Cortisol over sex steroids is due to the use of oxygen as the terminal electron acceptor in human mitochondria. Lack of catalase and UV light fuel this low fertility. Your eyes and skin are designed expect to see more short wavelength light like blue in the summer and the morning, and less in the winter and at night. With many living in a blue-lit world year round, you can see how (yet again) light is a drug and needs to be administered in the correct dose at the correct times.

Hi Dr.Jack, my mom this morning had some large polyps removed from her colon, her doctor is recommending she eat large helpings of fiber daily, your thoughts on this please as I am telling her to eat protien. Thank you

I would not recommend fiber for that problem Pat, because it makes no biochemical sense based upon how our biochemistry works. That is conventional medical wisdom however in a nut shell. The real cure for her problem is eating a paleolithic diet, and she needs to eat pastured butter (Organic Valley Special Edition May thru Sept. type or Kerry gold brand) and high supplementation of RX grade omega three's and 5000 IU of vitamin D3 to keep her immune system functioning well. (levee 5) Lovaza is available from her doc. Make sure she keeps it in the frig to avoid oxidation. You can use other brands too. For good one's go to http://www.consumerlabs.com for the tested brands you can trust. She also needs to pay attn to levee six and to levee 5……getting polyps is tied to lower gut immunity because of omega six generated eicansoids. This is what you get when you eat Dr. Oz's diet. In fact many of you may not know this……but Dr Oz suffered from this issue as well. Too bad Gary Taubes did not ask for Oz to get a colonoscopy when Oz asked Taubes to get his cholesterol drawn on his show. The beauty of science is whether you believe it or not…….it is still the truth. I live by human biochemistry, because it has not failed us in 2 million years as long as we eat they way we were designed. Tell your Mom Jack said that. She needs to change the way she thinks Pat and have a long talk with her physician.

Yes, I'd like to see the biochem please… why do you recommend three meals w/o snacks rather than 4-5 small meals please? I can definitely feel my blood sugar taking a dive between meals if I don't eat a sizable meal… and I never feel like eating that much at one time.

Why? my favorite question!…..4-5 meals consistently raises your insulin levels. Insulin is released biphasically, Short and long term. I would suggest you get a reference book like the biochemistry book link below to check this out. Anything that raises insulin chronically promotes fat storage when your leptin resistant and makes gluconeogenesis (glucagon) inefficient. Read my posts carefully, because the answer is already there. Your symptom is proof you have leptin resistance at your liver level. This information is in the leptin deux post! And it is contained in any biochemistry book on humans you find. The problem is diet guru's make their recommendations on others opinions. I choose to go use evolution's dictionary……2 million years of proven human biochemistry. And…….your blood sugar dives because you have hepatic leptin resistance and your liver cant stabilize your blood sugar because glucagon no longer is working. That can easily be fixed. You constantly eating just makes you worse because it increases your leptin resistance.

50 grams of protein upon waking…ok i can do that however it sounds contrary to what most have been advocating praising intermittent fasting for leptin improvement.

is this ok to do if I wake up with HIGH blood sugar levels? will be very different as i havent had breakfast in years but i suppose it will help sleep to not be full when i go to bed. getting my bio-chem book back out and rereading some stuff.

Thanks Doc… I should say that I eat about 1 cup of food at any of these "meals"…. it doesn't take much to fill me up and I don't really like eating a big meal… I started eating this way to simulate the size of meals that people with gastric bypass surgery eat… But I will give your approach a try.

I have one other question pls… fitness gurus say eat 10x your body weight in calories… I never ate that much in my entire life! When I've done calorie tracking, I'm eating somewhere between 900 and 1300 calories (wt.=235)…. do you feel it's necessary to eat more calories in order to lose weight? eg is my low calorie diet inhibiting wt loss for some reason?

we don't have any calorie rules in our dietary pillars…..if you understand leptin……you eat what you want and your body gets rid of the excess by UCP3 and UCP1 activation……..read my comment to Patricia knigge made tonight 6/6/11 . That answer feeds into your questions. This is how the quilt is designed to work. We will keep hitting the same levees over and over……and soon you will see how it all fits. And you will have that epiphany moment. Diet can be summed up with paleo…..focus on your timing of when you eat……avoid snacks and boom…… your skinny and not ever hungry and then you start feeling to lift heavy weights to look good naked. This is how I did it and how I helped many do it. You just need to be consistent and do more right than wrong. No rules……just different thoughts.

Dr Kruse, I don't know if I can eat within 30 minutes of waking, Eating in the morning makes me feel yucky. Why does that meal have to be 30 minutes after waking? I take omega 3-6-9 supplement, is that one okay or do I need to change it? I was excited to read how to reset the leptin sensitivity in this post! When do I need to start exercising? Also, why no aerobic exercise? I understand I want to build muscle but won't that help with that and also give my heart a workout? Sorry for so many questions.

ok…..im breaking my own rule here. THROW OUT your 3,6,9 and only take marine omega 3 supplements! That is my PSA for you. Why do you want to rise and eat that protein so quick? The food effects the gut's incretin system to stimulate PYY which immediately sends messages to the hypothalamus that you just ate high quality chow and we don't need to eat again for a while. So it in essence it shuts of all hunger signals (arcuate nucleus) and craving signals (NPY). It also helps shut off morning cortisol which sensitizes the liver to perform when fuel stores do get lower later…….in english this means you can go longer on the food you ate with out feeding again. Your liver is able to distribute its stored calories when you need them……and this ultimately results in less calories eaten and you have no hunger or cravings to boot. This sounds like an obese persons dream but I can tell you this is precisely the mechanism of how a paleolithic diet works to shred fat and weight. The more protein and fat you eat the less calories your brain will crave and drive your behavior to graze.

Next real bonus then occurs……this allows you to stretch your meals sometimes to once or twice a day. When you eat a calorie reduced diet without hunger or cravings……this is called intermittent fasting (IF). We are biologically wired for this because in paleo times we did not have 24/7 access to Costco's. And IF increases a cellular process called autophagy that increases our lifespan by recycling our cells and keeping our cardiac stem cells from being used up! Moreover, eating meat early in AM (bacon) provides us with a nutrient called carnosine which has also been shown to increase our telomere length. Anything that increases our telomere length increases our survival too. This is the great circle of life. Paleo is not a faileo diet. Eat meat and eat it as soon as you rise.

Im very strict about my timing of meals now……the food itself just needs to follow paleo dietary pillars. You mentioned your heart……….IF stimulates autophagy to save your heart cells from getting taken out! The Circle of life is now complete. Why no aerobics? If you are leptin resistant exercising increases ROS at the muscles which can use the excess calories so the fat there KILLS the muscle cell and recruits a new one to develop, You just used up a stem cell that you did not have too. You just lost time on the end of your life because you decided to do aerobic exercise which added stress to an already stressed leptin resistant cell. No trainers seem to get this. Never use aerobics when your leptin is not working well. You will lose weight this way…….but exhaust your stem cell supply. That trainer wont be there when you're dying at 55 because you decided to marathon run to lose weight.

Yes, Mal you are trying to overcome hypothalamic amenorrhea, you should be eating first thing in the morning.

This was one of my favorite parts of Mastering Leptin, it explained so much that I hadn't known before. It's good to see someone else talking about this stuff.

I'll give the protein first thing in the morning a try. I have been doing very well fasting until noon, but then again I'm lean with no problems so maybe I'm getting away with it but could do better. Great tip, actually I do remember Byron Richards mentioning that many times but it just never clicked that I should be doing it, it's a bit of a drag to have to cook that early, would some beef protein isolate and coconut milk work?

You need four hours of no insulin spikes for leptin to bind to the hypothalamic receptors to allow them to work. So if you meals are late…..your sleep is shifted. It can still work but you have to adjust you sleep to get the 7.5 hours you need to make sure you are controlling the hormone signals.

I work with some gals (including myself) who are Paleo (ish) and are Crossfit (ish). It's been messing with our hormones – no monthly visits, etc. So this got me to wondering if this whole Paleo gig was optimal for dudes and needed to be tweaked for the ladies. (I am including Crossfit style exercise in the whole Paleo lifestyle as it seems to go hand in hand, at least these days). This is really shining a light on why we are encountering problems. Can't wait for more. Thank you again.

(PS I see you making YouTube clips with a white board for us visual learners – wishful thinking? ;0)

Nothing before bed for three to four hours. The reason is to make sure insulin in the blood then is not present. If it is present it wont allow leptin to bind to its receptors at the brain. And if that happens the brain is disconnected from its gas gauge. It has no idea if the tank is full or not.

Interesting you say that about protein within 30mins of waking up. There has been a bunch of talk about Tim Ferriss's recommendation that you do that on his "Slow-Carb" diet from his new book (modified paleo diet, basically). It's one of the points he makes repeatedly, but I have seen people argue about it being quackery on different forums.

I just looked and I don't see that Tim actually gets into the science of why that works, rather than just the anecdotal evidence that it worked for his father to lose an extra 5lbs a week with that change alone.

Im not a fan of Tim's ideas because they work for him because he is clearly leptin sensitive while most of his readers are not. The protein load is important because it controls the incretin signaling system in the gut. This along with leptin modulates hypothalamic signaling properly to restore the thermostat effect leptin has on this part of the brain. Timing is more important than food choice.

Question: UCP3 is down regulated during lactation (an activity in which I recently participated). Does this mean leptin is also down regulated? Does this explain lactational amenorrhea? And how long in your opinion post lactational period would ucp3 and leptin function be restored? Poo. That was more than one question. Sorry 🙂

UCP3 has nothing to do with lactation. Leptin has a ton to do with it. A woman's milk wont come in if she is leptin resistant. In fact many papers in the OBGYN literature show that breast feeding is down in this country because many young mothers suckle reflex is broken. The oxytocin signal from nipple massage can not overcome the extreme cortisol surges from leptin resistance. When a woman has gestational diabetes the chances are dramatically reduced that her milk comes in and her child gets their hypothalamus booted with the leptin signal. Longer term gestational diabetes is an excellent predictor of future type 2 DM development. That is how powerful leptin is to momma and baby. And the child's metabolism can be broken in-utero as well by epigenetic effects of leptin on oocyte development. When you understand the biologic power of this hormone then you truly understand why it dominates and controls the other hormones that control how we behave and live.

I'm not very science-minded, so this may be clear to others. By following this, would it result in the reversal of hypothyroidism? I've been Paleo for about six weeks now, got rid of cravings, just added weight lifting, but I still have my Synthroid crutch, and I'd love to get rid of it.

Nicole you don't have to be science minded. Just keep reading and as I build it out you will get it. When I get to the hormones and their integration I bet you will most definitely get it. The quilt will give a reader a 30 foot view of the problem like a PhD or researcher would see and then it will also give the lay person the 30,000 foot view of seeing the entire forest through the trees. But to get there you must build it piece by piece. If I unleashed this in a week no one would read it because it would overwhelm your ability to stay up with the shear volume of the information. But I will give it to you and I know you want it and I know you will use it in ways none of you thought possible.

I have tried to quit all artificial sugars/sweeteners several times and have failed because of extreme fatigue and severe cravings. I am one of the most sugar-addicted people you will meet. The last time I stuck it out for 22 days, and was following a paleo diet but was eating 1 fruit/day and sweet potatoes. Is this a candida situation, or did I just not stick it out long enough and needed to eliminate the carbs? Have you experienced this with any of your patients?

Glad you like it. I know I can not please everyone but my goal is to change the paradigm i have to practice in. I believe if I can help you understand WHY things happen then you can have more control of your health! The topics you want to hear about will be covered in due time. I have to get The Quilt to have some more substance in each levee. Most people don't understand many of the technical nuances of the levee but often that is not important. What is important is to realize there are 30 levees to protect your cells from disease. The levees are numbered in order of importance based upon my reading. The person can then make a decision of what to apply to their lifestyle based upon their particular needs.

Hi again, ok I got the butter you suggested & the vitaminD3 it's 1000IU so I should take 5 of them to equal 5000IU right? Wasn't able to find the extra virgin cold pressed coconut oil or the RX Omega3 fish oil?? Oh yeah kombucha is kelp (yes) cause that is what I got (lol) also no luck finding fermented veggies?? Leptin Doc said yogart is ok and cottae cheese to bump up my protien in the morning is this right??

The terms "extra-virgin" and "cold-pressed" have been borrowed (by some people) from the world of olive oil.

What people normally refer to with good quality coconut oil is "organic virgin coconut oil", at least in my experience. It is true that it should be processed without chemicals or high heat, but I have not normally seen it being referred to as "cold-pressed" in the title anyway. (But look in the small print). I hope that helps when you are next on the lookout for it.

I have a really hard time eating something as soon as I wake up, is it possible to just have two meals a day? Like a late breakfast and dinner (within the timing parameters)? Or does that completely miss the point of eating so early in the morning.

Robyn read my reply to Jac above. Its best to eat then but it is not axiomatic if youre already fit. If your obese you better reconsider your position. Because what I recommend is optimal for our brain chemistry. Don't embrace your feelings in this matter. Change your thoughts on it. If something that simple can be done why not try it for 30 days. What do you have to lose except fat?

A fermented veggie is sauerkraut, or horseradish. Make a salad dressing with them. Also very cheap and easy to find. Same thing with dill pickles. Kombucha is at whole foods and the coconut oil can be bought on line or at the vitamin shoppe in rivergate. I use Nutiva brands. If you friend Chris Foley on FB he works for them and is a great guy. Friend him thru Nutiva and tell him I sent you!

You lose CCK when you lose the GB. It may not be a problem but high fat diet can cause the runs. I would use probiotics with some bile salts and you'll be fine. You must remain paleo, but maybe you up the protein over the fat. Coconut oil is awesome so dont miss out on its benefits.

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With havin so much content and articles do you ever run into any issues of plagorism or copyright violation? My site has a lot of unique content I've either written myself or outsourced but it seems a lot of it is popping it up all over the internet without my permission. Do you know any solutions to help protect against content from being stolen? I'd really appreciate it.

Let me get this straight to become leptin resistant a person should skip/eat low protein breakfast, snack constantly, eat a lot of carbs, eat late at night/before bed and do a lot of chronic cardio. Well dr k, that would explain a lot about my life and "battle" with hunger, weight loss and periods. So glad I can start turning this ship around in 6-8 weeks.

I'm on day three trying this system and am very surprised by how good I'm feeling. Usually I didn't eat until around noon, and snacked more than had meals. I did have the hanker to snack, but checked it. I was also eating very low calories along with low carb, so I'm going to be interested what affect eating closer to 11-1200cals will have. I'm going to give it the old college try and keep at it for eight weeks. Will report my findings.

@sage……calories mean nada to me. They matter when your leptin resistant for sure. When your leptin sensitive you can burn excess by activating UCP1 in cold temps or you activate UCP3 to burn them off in times of calorie excess. But as my post clearly laid out to do so you must be leptin sensitive and have good T3 and T4. In this country many dont because the SAD is the big problem.

This information is critical to get out. I think you're making it understandable and it is very well written. Moreover, not forgetting to mention that it is incredibly informative likewise. Kudos to you and to the excellent work you are trying to carry out here for the public!

@Jack, i apologize for not providing context for my question. would it be optimal to consume only the calories needed for normal body functioning? will this speed the process of becoming sensitive to leptin? also, i understand that carbs must be kept to less than 50g per day, but what if i go less than 20g to be in ketosis? will this speed the process? or is time independent of these variables?

Howdy! This is my first visit to your blog! We are a collection of volunteers and starting a new project in a community in the same niche. Your blog provided us valuable information to work on. You have done a marvellous job!

i am on day 6 of my 50g protein wakeup call and have a new challenge. i am a shift worker and for the next two weeks i will be keeping unnatural hours. will the same rules apply? or will i need to make some alterations?

Very impressed with the information that you've put up for us fellow netizens. Extremely comprehensive and properly-composed. And this article is one in which a lot of people will definitely be able to reap lots of benefits from. Keep them coming in to read more of such articles… Cheers!

Hi I'm a FAT, 52 yr old nurse. I was always thin and healthy and worked out and played sports. I gained 40lbs my first quarter at nursing school (not my first degree) 20 years ago and I am 211 @ 5'6" to date.

I thought it was adrenal fatigue……My 2 early teen boys do cross fit and I saw the Paleo diet, I turned away because…..seriously….no rice or potatoes or bread?? EVER??? I want what you describe. But I love rice and potatoes and bread!!! Is this true???

I did not see an answer to the question about protein within 30 min of awakening and synthroid which requires waiting for at least 30 min to an hour before eating. Also, is it possible to get off of the thyroid hormones? I take both Synthroid and Cytomel. Thank you

@Lynn Dont think……check it. A salivary cortisol level, rev T3 and estrogen testosterone progesterone levels will open your eyes. I also would get a HS CRP and vitamin D level. Once you have those as a baseline you can help your doc begin to help you. Your boys are very smart. Mom needs to learn from them because they are doing it correctly. That is how this doctor lives and my entire family lives as well.

Do you have an opinion about whey protein powder? Sorry if it seems a silly question, but do you anticipate the same appetite and energy effects with a protein smoothie? (The smoothie you describe above wouldn't get you even close to the recommended protein level for leptin correction, so I'm guessing that once leptin sensitive the protein level can reduce quite a bit). I'm asking because 'technically' I'd have the same macronutrients – 50g protein, coconut cream, and blueberries that I've had with good effect in the last few days, but it would digest much more quickly than my solid breakfasts.

Been reading and thinking and trying to see the big picture here. If leptin is the primary hormonal signal and it's proper functioning effects everything from inflammation to fecundity to immunity to metabolism, and it seems nearly all of our cells have receptors for leptin, and it is mainly secreted by our white adipose tissue, does that mean that our state of health is ultimately dictated by our fat?

@meredith…..nope. It does mean that what controls energy biogenesis is critical. The next step for you will be to realize that the key to cellular health is the mitochondria. Because that it is where energy generation occurs. Leptin is important signaling hormone that allows the brain to transduce the signal from 50 trillion cells to get a sense of what is occurring in your body. The mitochondria are the genesis of where those signals begin.

i'm loving your blog! i'm already eating paleo/primal but i've been stuck in a stall for a few months and i still have a significant amount of weight to lose. obviously i'm leptin resistant. are you going to give specific recommendations of what to do? is it just eating 50g of protein within 30 min of waking? thanks for the help!

i am now on day 7 of my attempt to become leptin sensitive and i have noticed a change that i find scary. one hour ago i ate 3 eggs and 4 slices of back bacon slow fried in coconut oil and i don't feel "stuffed". i went back and reviewed my food logs and this started 3 days ago. on average my calorie consuption has gone up from 1300-1400 calories to 1800-2200 and carbs are up from 20g to 30g. last night i went to bed hungry! is this normal? i am a 48 yr old female; 5'5", 126 lbs (down 2 yeah!) trying to lose the last 10lbs of "apron" fat.

@Jenny Rule one is never miss breakfast and eat 50-70 gms of protein with some fat. Avoid carbs if you can.

Rule two is no snacking at all but especially after dinner.

Rule three is a strict paleolithic diet.

Rule four is timing. its based upon your day. eat 6-8AM, 12-2 PM, 6-730PM. If your day fall differently then adjust. Meals need to be spread out to give the liver time to use gluconeogenesis again. I hope this helps you Jenny!

@sage no its not. I would dial down the carbs and I would tell you to up AM protein and maybe skip lunch and eat a larger dinner. I bet the reason for this is your liver is not ready for the change. Keep being consistent. And sage at your height and weight you may already be leptin sensitive. I would say get a reverse T3. If its ok then you dont need this protocol. This is for overweight or severely underweight folks.

is the accumulation of fat in my mid section caused by something else then? other symptoms that led me to believe i am leptin insensitive is constant feeling of weakness in my muscles without the 150g of carbs a day i no longer consume and absense of fat everywhere else; people ask me all the time when i'm due!!!! and just to eliminate the question of abdominal strength, i can hold a plank for longer than 3 minutes without breaking a sweat. i have been aggressively trying to lose this fat for over five years.

I know that what you write is true because I have been there done that and know that it works for me since I am insulin resistant, hypothyroid and overweight. Limiting my carbs as you mentioned and no aerobics works for me and 9 weeks is when I begin to see a difference so you are right about using weights. Looking back, I realize this has been true my whole life and instinctively I knew to lift weights and eat 3 meals with protein for breakfast as you described with no snacking after 7 at night since I go to bed early. I must get back on this routine now that you have confirmed it for me.

thanks so much for the rules, dr. k. i've been doing paleo for almost a year and i've lost almost 50 pounds… but i probably have 75lbs or so to go. the last 3 months have been a total stall. since i read your blog re: leptin, i've stopped snacking and i've been eating protein for breakfast everyday. i already feel really good… SO much better since adopting a paleo diet 11 months ago… but how long following your rules before i see/feel a change in leptin sensitivity?? should i feel something different or just notice weight loss again? thank you SO much for your help and generosity of information!

Jenny it usually resolves in 4-8 weeks. That is what I have seen over the last five years when the patient is doing all the correct things. You wont feel anything but your carb cravings will go completely away and your sense of taste and smell will improve. You will also notice your clothes fit better even if the weight is not changing. Stick with it and the weight will fly off. This is when you should begin lifting weights. Heavy weights.

Thank you so much Dr K. Finally someone with some sense that will talk to me and help me. I love your site and your approachability. I have a million questions, but need to read everything first and may get some answers. Thanks so much! You are awesome!

I've been on your protocol for over a week now, and I am truly impressed by how my cravings have minimized. The urges may come up when I walk into the kitchen, or do my marketing, but I can dismiss them fairly easily now. Thank you for this simple, yet so effect plan. I never thought I'd be eating breakfast again, much less 5oz of london broil!

I am taking the plunge and using your diet program because the leptin issue sounds like mine. I will be blogging about my experience and also discussing it with my peers at Mark's Daily Apple. A good question came out of that discussion:

If you're giving up aerobic exercise and not lifting until you can answer those questions, will you be exercising at all?

What is the answer? Should I be taking slow walks? Yoga? or just wait the few weeks until the weight lifting begins?

@KYM it depends when you start. If your leptin sensitive to begin and trying to lean out sure you exercise. But this information is for people who are overweight who can not lose weight. This is the biochemical pathway of why it wont work. If your rev T3 is up you need to become leptin sensitive first before you go crazy exercising. The point is made in the post, if you exercise and liberate fat to burn as energy while your leptin resistant your muscles can not use the energy because UCP3 is turned off. That makes the patient fatigue faster and abhor exercise and they will lose no weight at all. Thousands of people live this and no one out there is telling them why. This is why. I think yoga and walking are fine if your beginning. You lift when your leptin sensitive and not before.

I have been about 60/40 primal since March 23. Did the Whole30, lost 13 pounds, then became imperfect with paleo and weight sort of yo-yoed 5 pounds up and back down. I've been jogging for about 8 weeks. I have 60 pounds to lose and have not been able to take off more than 20 before going right back up for over 5 years, since a year of ill-advised antidepressant use. I think I will do low impact exercise for a couple of weeks and see how it goes. I can jog once the experiment is over. 🙂

For over a decade I have had a hard time with all exercise. It wipes me out for a really long time and I seem to have a heart rate the is abnormally very high during exercise. Keeping my HR down I can move around without fatigue but if it goes past 125 (I'm 32) then I'll usually feel tired for several days. I've been to many Dr., cardiologists, the Mayo Clinic and they have found nothing abnormal about my heart other than my HR being high as described.

After reading this, I'm wondering if leptin could be an explanation? Your description of how the muscles are unable to use the energy really gave me hope. I'm not more than 10 pounds over ideal, but have a history of extreme dieting (always unsuccessful too). I know your not here to diagnose and help individuals, but I sure would appreciate hearing any thoughts you have on this, as I've spent tens of thousands and most of my youth looking for answers and I think you may have touched on something that could really make a difference for me.

I have been reading your site with great interest and feel discovering you and your science landed in my lap with perfect timing. I have been eating a low carb that is slowly moving to a more paleo/primal diet for about 9 months. I have lost nearly 50 pounds, but seem to be stalled/plateaued now for the past 4 months. I was searching for ways to break that when I came across your site. I can answer yes to all of your questions above regarding LR. I have been doing 60 minutes of Zumba two-three times a week and 60 minutes of walking on alternate days. Today I started your recommendation for the larger protein breakfast, no snacks etc. Should I replace the Zumba now with weights or add them in on alternate days? I am 38, 5'5", female and currently at 215 pounds. Most of which I carry in my mid-section.

I'm 41 and I've been eating paleo for about 18 months now and have had fantastic results — dropped 20 lbs, no more chronic URIs, achy joints, or tendonitis. I lift weights 2x a week and do sprints or HIIT 1-2x week. But my weight loss has stalled. (I'm 5'10" and 188 lbs, so not obese but not yet lean.) Have tried IF recently in an effort to break the plateau. 16 hour fasts (8 of them sleeping) with an 8 hour "feeding window." But I find myself light headed and spacey. Curious if I should try the leptin-sensitizing protocol you suggest to recalibrate before pursuing IF….

Thank you for your informative blog! I lost a bunch of weight on a lower-carb diet, but the last few pounds have proven to be difficult. I find that I can get into a metabolic funk after something simple, like a few carby meals or some additional stress, like overwork. Then I find that it may take me up to a month to get back into balance. Cravings come back, sleep is disrupted and energy is low. If people have fixed their leptin resistance, is it possible to get so out of whack so quickly, and then have to do the long slow slog back to balance?

Also, I lost my weight after starting trazodone for sleep after menopause. I noticed that I'll have to wait till levee 28 for the sleep discussion, unless you move it up. It was a delicate balance between keeping my carbs low enough to eliminate cravings and keeping them high enough to sleep. It took me quite awhile to figure out what kind of food to take with the pill at night. I finally found out that it had to be a carb in order to work, so I started taking Dr. Eades' advice, a spoonful of sugar. Works like a charm, but it violates the simple and finite rules to leptin sensitivity. Will a spoonful of sugar wreck the protocol? The alternative of course, is not to sleep, and I don't have to tell you that all hell will break loose weight-wise if I go there again.

Do you have any better suggestions? (I am on a lower-carb semi-Paleo diet.)

@Exceptional Sugar will destroy the leptin protocol. The real issue with sleep is the clocks. And I will be hitting this sooner. We have clocks in many places in our bodies for sleep. The liver is one and so is the hypothalamus. So if they are not all synched you can be out of whack.

What other signs show that your body is becoming leptin sensitive? Will it be the breaking of a plateau and weight dropping off again, or is there another way to tell? Will continuing to do three hours of cardio a week prevent it?

I'm trying to figure out if I'm leptin resistant. I've been losing .5lb/week over the last year (ever since narrowing from a WAP diet to a primal diet), until two months ago when I started six weeks worth of weekend sugar binges back up. (Sugar indiscretions over the previous year were very few and far between.) So I can lose, as long as I stay away from sugar, but never more than .5lb/wk. I'm still probably at least 30% BF, weigh 152lb at 5'4", have a huge, chronic bloating problem even when eating well, seem to be pulling at least partially out of five years of chronic fatigue, & have horrendous sugar cravings when I increase fruit or starchy veggies or any other big carb source.

I didn't know to get reverse T3 tested. I have these results from my March blood tests:

WBC – 5.5, Ferritin – 142, Insulin – 4.8

TSH – 1.430, free T3 – 2.5, free T4 – 1.17

Vitamin D was 26 last fall before I began supplementing around 6000IU/day most days.

Triglycerides were just below 100 and my HDL was around 70, IIRC.

I have never had any trouble making enough milk through five births and 13 years of lactation.

The sugar cravings started after serious antibiotic abuse about 10 years ago, and the fatigue and first instance of visceral fat in my life started around 5 years ago, when the sugar cravings were at their peak, before I realized I needed to increase fat & protein and get off processed food. The 10lb I gained from this most recent spring binge went straight to my belly, then finally hips/thighs.

Am I leptin resistant? Is everyone who has abdominal fat?) Was I pre-primal, but now am not and shouldn't bother with the 8 week experiment? Was I, but stopped, and re-started with the spring weekend binges?

I see why 50gm is better than 18, but how do we know what the upper and lower bounds are? Why not 25 or 150?

Can I drink herbal tea or ACV in water in the three hours before bed?

Most storebought sauerkraut & dill pickles are not fermented any more, or if they were, they've been pasteurized. The Weston Price Foundation has lots of great info on how to ferment foods, and how to find premade foods that are actually fermented and not pasteurized to death.

Over two weeks and gettinng 6-7 hours sleep nightly. I haven't had this much uninterrupted sleep for early ten years. Weight is also beginning to shift, but I will stay with this for the sleep alone. It was a dreadful lack of sleep and resulting stress that led to my weight gain in the first place.

I'm wondering where thin people come in here re: Leptin. I was an underweight child, teen…till around 28 yrs and taking paxil (carb cravings I assume). I'm now again thin, and I have tested saliva cortisol and it is low throughout the day.

My daughter (17) is the same. We would do almost anything to gain weight. Weve had to watch her with sugar as she also suffers from acne and we have to be careful with insulin resistance and her ovaries-androgen production. Actually her being on thyroid meds have helped her acne tremendously!

What makes one thin to underweight? I know the majority of people want to lose weight but I know what it's like to be too thin and it is most definitely an issue.

Dr Kruse-I would like to learn more about your coconut smoothie and the biochemistry behind this recommendation.Also,I have read that raw eggs are not well absorbed.Could you elaborate on that,and if true,would digestive enzymes improve this absorption?…Thank you

Looks like a 10 lb loss the first week! Holy moly, I've struggled to get that off in a month! This is an experiment I love. I really would love to start crossfit in July, but I am assuming I should wait until after week 8? Patience is hard. 🙂

@Mandy leptin plays a role for thin folks…..but abnormally thin folks. It also increases rev T3 when your starving yourself. If your rev T3 is not high and your not gaining weight and you want to…….well here is the answer. Eat carbs. Eat refined carbs. And the weight will come.

Can you give some practical guidance on how to manage the 50 grams of protein? I'm trying to advice my friend who is leptin insensitive.

She keeps kosher, so bacon is clearly out. It would be inconvenient in the extreme for her to eat any kind of meat in the morning (would mean she can't have a morning coffee, for instance because that has milk).

2 eggs with butter and 5 cubic inches of brie (who can eat that much???) comes to only 30 gm. of protein. Would this do the trick? I can't even begin to imagine eating 3 eggs in the morning, and she'd probably be less willing. Maybe 50 gm. protein is more suitable for a man than a woman.

Any advice on how to put this into practice would be greatly appreciated. Thanks. BTW, she's a 55 year old woman.

She should have her coffee with heavy cream as I do. The meat issue is easy. Crock pot a slab of grass fed meat the night before and cook over night ten hours and it's ready in the am. You can then eat it or put it in an omlette. I also use raw eggs in smoothies on work days like today. Four eggs get real close to fifty grams. Last choices would be whey protein or protein shakes that are pre made. They are processed and I would not touch them myself but if you allow you thoughts to make you accept a C or D that is going to effect your optimal goals. That is not an option for me at all.

Do you believe people who gain weight with age (and hard to get rid of it) is actually due to slowly becoming leptin resistant? After all, I doubt its due to "slower metabolism" if leptin really regulates our appetite.

Also, since leptin controls appetite, and America is getting more obese (paralleling increasing fructose consumption) in the last 3 decades, do you think it has to do with fructose's effects towards leptin resistance?

@Dan depends upon how out of shape you are now. If you're morbidly obese walking is all I would recommend. Most people who are morbidly obese do not even realize they are. If your over a bmi of thirty you are. If you're twenty five on a bmi to thirty I would walk and lift heavy weights. If you're twenty to twenty five on a bmi then you can do HIIT full-time with sprints. I don't advocate any aerobics at all.

The reason I asked about the bio chemistry(coconut smoothie) was because your June 6th post mentioned that it was very detailed and if people were interested you would post it at some point.If that is not necessary,I understand….I tend to have a geeky fetish for details.

I didn't make myself clear. Meat at breakfast is simply not an option for her, for religious reasons. I suggested some combo of tuna / sardines / eggs / cheese.

I agree with you that protein shakes are not the way to go.

Cream is fine, but it mainly adds fat, and very little protein. Actually, I see in fitday that it adds more carbs than protein. 🙁

She doesn't have a huge appetite. She's a 5'1" post-menopausal woman. I don't think most women can eat 4 eggs. I couldn't. I'm just wondering if the requirement for a short woman is the same as for a 6' man.

And the 60,000 question. If she manages to eat on average let's say 35 gm of protein for breakfast, will she simply stay leptin insensitive? Doomed to failure?

@Ruth. Sorry I should have picked that up. She can try lower protein intakes but she needs to monitor effects for her N-1. I love when people do self experimenting. It helps you learn your body much better. Just tell her to observe the effects. If I can help further just ask

@jem If you want to heal you should go all the way. If I was removing your brain tumor would you want me to stop half way through? Same thing with the dairy, caffeine and coffee? Why settle? For me personally I don't settle. I usually wont let my patients settle either unless there are good reasons.

I saw in a previous comment that you recommended walking only for people with a BMI above 30. Is there really no benefit to lifting heavy weights or HIIT or something like crossfit until I get my BMI below 30? I'm at 37 right now.

Still trying to figure out optimal choices for the 50 gm protein breakfast.

1 cup of cottage cheese has 27.1 gm. of protein.

1 cup of cream cheese has only 17 grams of protein. But it is also so heavy – it would be nearly impossibly to eat. So for this high protein breakfast, a relatively low fat cheese like cottage cheese is a better bet, right?

@Jenny…..is there a benefit…..yes. It is small. I advocate lifting heavy over just about anything else. @ Ruth…….the protein level is Ok but I loathe cottage cheese because of the insulin spike it gives most of my patients. I want protein load with minimal insulin spike…….MEAT or EGGS!!! sorry but I always advocate science over any other issue. I am a pain in the ass I guess.

Wow, thanks for staying so involved in this comment thread. I am not overweight but trying to lose the last 5-8 pounds to get rid of fat on my thighs. I am 47 years old and gained 2 pounds last fall; nothing I tried worked to get them off, and I'm not ready to give in to middle-aged weight gain. I tried slow-carb (gained another 4 pounds), then 4 months of full Paleo, with no weight loss. I started following your rules the day you posted this and lost 3 pounds the first week. Then constipation set in. I haven't had a thorough "elimination" in the past 10 days, and I've gained the 3 pounds back, along with the inches I lost the first week. I'm prone to constipation anyway; any quick pointers before you get a chance to post about that levee?

@JenCab this is a common compliant is directly tied to the change in your but microbiome. It generally takes 4-6 weeks to pass but I advocate 800-1200 mgs of mixture of Magnesium (malate, glycinate, acetate, oxide) I also advocate using coconut oil and pastured butter liberally during this time. Moreover, you need to add fermented carbs to your routine. Things like dill pickles, kombucha, home made sauerkraut, horse radish, and cabbage. I personally eat these things routinely to keep my gut health ideal. My wife makes smothered cabbage in coconut oil at least once a week now. I eat dill pickles with regularity as well and I still put a heaping table spoon of coconut oil directly in my coffee at times too.

Jack love your blog, I have used carb restriction to drop 70 kg in the last 2 years, being six foot six I had convinced myself i looked ok at that weight, Like you i have used resistance training , and to use the comment now look good naked. life CHANGING COULD BE SOMEWHAT OF A UNDERSTATEMENT, Would you have a opinion on Supplementing with CLA I feel its helped with the last few kg,And plan on using for a few more months to continue maintenance weight values. The rest of diet is as per yours or the style of LOW CARB HIGH FAT MOD PROTEIN but still replace some meals with Whey isolate and coconut oil and water,EFA are used in my diet as well, Great blog having someone of you profession, and also having your own experiences with this approach only adds validation the the unconvinced. Thanks walter

dr jack, this blog is absolutely amazing, thanks so much for putting in all this work.

i'm a 39 y o female, 5ft8 and 164 lbs, body fat at 29 per cent. i've been a vegetarian for 23 years (epic fail), resulting in a lot of health problems (ferritin nearly completely depleted, my doctor put me on an iv drip twice weekly for half a year). i went paleo a year ago, keeping carbs at around 70g mostly, and could not lose any weight at all. none. i want to lose at least 20 lbs but i'm really getting frustrated by now. didn't i do anything "right"? is it because of the leptin? what do you think? thank you very, very much for taking the time to read through all this.

@Walter……used to be a huge fan of CLA but the last three years the data has been unimpressive on CLA. So I no longer use this as a supplement. If you do raw cream youre getting it. Thanks for the kind words. I'm trying to help us all……we are after all in this all together.

Nica you likely do have leptin issues but your vegan ways may have toasted your HPA axis……so I would strongly suggest you make a rock solid foundation change. I will soon be blogging a basic how to leptin/Paleo prescription. I think you will like it. I also think Robb Wolf has some great RDA on his site who can construct a plan for you but I do think you will need a doc to check all your hormones once you get the paleo fuel right and eat that fuel using leptin principles.

even when i was a vegetarian i did not eat any processed stuff, nor sugar, nor soy. i didn't drink any sodas or stuff like that, only plain water, tea or coffee in the morning. carbs were around 140 g mostly, but protein significantly lower. but i still got fat, and even a daily nordic walk of about an hour didn't change a thing. i had to stop the walking routine when my ferritin got too low because i was so exhausted all the time. but after a year of paleo now i feel much stronger, and i don't crave food. usually i have 3 meals a day, sometimes 2, and i only eat when hungry.

Hi Dr. Kruse, thank you for this information and your recent post yesterday on how to start the process. I have been paleo since Oct 2010. I am 5'11" and 145 pounds. Not heavy, but my % of fat is increasing with time. I am now around 29% fat, so skinny fat. Last fall my RT3 was high, my night and morning cortisol are high and have been for years. I am on Cytomel and Nature thyroid and I have been working with a doctor to correct my leaky gut, immune system, chronic fatigue and other health issues. I just started the 50g of protein this morning. I am averaging around 1960 cal a day with 8% carb or 15 net carbs, 69% or 151g of fat and 23% or 116 grams of protein. Does my profile look like leptin resistance? If I start the day with 50g protein, do I follow the other 2 meals with aprox 25g or do you recommend more? I feel hungry a lot so I think the higher am protein will help. Also, what are your thoughts on coconut products like the full fat milk, flour and shredded coconut all from good sources? I also take the coconut oil each day. Thank you for this information and putting this out here for us folks who are searching for answers. Have a great Fourth!

@Kami,,,,,,you need a good work up. Your body fat does not compute with the numbers you listed so it tells me there are other reasons for it. I do think leptin could be an issue for you but it appears you maybe having an issue at the liver level or at the muscle level and not centrally. You need more than I can give you on the net. My suggestion is you get in to see a doc and get optimized. Good Luck PS. Love coconut oil and milk and shredded unsweetened coconut but hate the flour.

What an amazingly helpful site for those that want the truth. Thanks for all that you do!

I am a 5', 8" 170 lb 36 yr old male with approx. 15% body fat. I am averaging 50G of vegetable sourced Carbs, 100 G of Fat and 125 G of Protein per day. I lift heavy weights 1 day per week and do aggressive push up, bodyweight squats and pullups about 5 times per week.

I know that you have stated repeatedly that aerobics are unnecessary, but how do you feel about the Insanity Workout? I'm on day 8 of 60 days in the program and have joined with co-workers for the challenge and endurance improvements, as I'd like to see if I can complete the course at this point in my life.

HI Dr. Kruse. I did leave some info out now that I have read more of your site. I believe I have put myself in the starvation mode for the last 28 years, just to keep my weight down, because of some unknown issue that caused weight gain and fatigue at a young age. I have struggles since the age of 14 with weight gain and fatigue. I am still hoping to get it fixed. What ever "it" might be. I have just recently bumped my calories up to the almost 2000 and with the controlled carbs, I am not gaining weight. Just to let everyone know, I have been doing the 50g of protein at breakfast without carbs with just 3 meals and no snacking since Thursday. I feel so much better and I really like not being hungry. What a blessing and it will be so beneficial to my body. This site just lights me on fire for this information. Keep it coming. I have ordered the Robb Wolf book and look forward to reading it. I am working with a knowledgeable doctor and I will be visiting with him this week about this site and what you have said. I know that I have issues with feedback loops in the pituitary and hypothalamus. Thanks again.

@Kevin you have so much going on now I think youre making it too complex. If you want to try the Insanity work out do so. I think you need to eat fat and protein and limit your carbs follow a sensible work out plan using HIIT and you will drop your weight. IT may not happen on your time table but it will happen.

Sleep just keeps getting better. I'm now getting 7-8 hours nightly. No other single thing could have so clearly highlighted the positive effects of leptin for me. I'm starting week six, and can't imagine ever doing without my morning protein and continuing the no snacking. Thank you again for giving me restful sleep! I thought I'd never have an uninterrupted night again without sleeping pills.

Question about exercise. My BMI is between 20-25. I was thinking exercise was to be avoided until LS started. But is HIIT okay for me at this point? As long as I do it in the evening, past 5pm? And can I lift heavy weights now? Thanks.

Jack, on June 22nd you wrote: Four eggs get real close to fifty grams.

Um, not actually. One(1) large chicken egg weighing 50g. has 6g. protein, so four of them would contain only 1/2 your 50g. minimum. Add a nice 4-6oz. grass-fed steak to the eggs, along with a good forkful of kimchi or some sauteed mushrooms, and now we're talking breakfast!

Your readers can easily look up the nutrient content of just about anything at the extensive, user-friendly & free site http://www.nutritiondata.com

@cbg.With the RT3 labwork, you are not necessarily looking for an absolute high Reverse T3, though that in itself can be a good clue. Instead, you are looking for a problem in the ratio between the RT3 and the Free T3. i.e dividing the Free T3 by the Reverse T3 (Free T3 Ã· RT3). For healthy amounts of RT3, The ratio result should be 20 or larger. If its lower, you have a an issue.

Thank you for all the information and your time! I am 53, post menapausal and if that were not enough challenge to losing weight, I also have severe sleep apnea (using Cpap for 3 years). I have been low carb for 2 1/2 years. The good news is I have normal bp, good lipids and have lost 60lbs. Bad news is it has taken 30 months to lose those sixty pounds and I still need to lose 130. At this rate I have to hope to live to a very ripe age in order to hit my goal weight. I started on the leptin reset July 8th with great hope this is the "switch" my body needs to lose on a more consistant basis. I'd be grateful for a pound a week–would sure beat the pound every four or five months.

thank you for a very informative website. I have a question about wine. I like to have a glass of red organic wine with my meaty dinners. Any objections to this practice? Wine is fermented alfter all 🙂

another question. What is your view on food sensitivity blood testing? Worth the money or a pseudoscience?

@Quest If your leptin resistant I would refrain from wine until you regain sensitivity. It really causes too many issues. Once sensitive then I have zero issues with red wine. I generally push red wine high in resveratrol because this sirtuin is another levee in my Quilt. Those wines are Argentine Malbecs and French Pinot's. Cali reds tend to have low content due to all the pesticides used. If you are drinking organic reds you might be better off but I would send a sample to consumerlabs.com and have it tested. That is how I came up with my two recs.

The main reason I drink organic red wine is that non organic red triggers migraines. As much as I like to consume different wines (a big fan of French wines), I am afraid to even sniff them.

I am a registered nurse. I remember one day in my physiology class I learned that sex hormones (among other things) are synthetized from cholesterol. Right there it occurred to me that there is something wrong with American obsession with low cholesterol diets. I love eggs, eat a lot of them, and consider them the most perfect superfood. You should have seen and heard lectures i heard when I ate them in public. I probably looked like I had a death wish.

Fast forward to more recent days. As a home health nurse I used to visit patients at their homes. I clearly remember my poor diabetic patients struggling for blood sugar control on CW diet. No matter how close they followed their ADA diets, they seem like failures because of fluctuating blood sugar and constant medication adjustments. Dare I say that our traditional medicine was killing them?

By the nature of my current job I read H&P of multiples patients all day every day. It is very depressing. The number of neoplasms is so prevalent that I do not think it can be all tied to smoking, sun exposure and genetics. I think it is diet, pesticides and lack of sun exposure. Coming from a different culture, continent too, I cannot recall that someone in my neighborhood had cancer. Of course we heard of incidents but they were far and in between. While people smoked, were exposed to pesticides and sun bathed, there are a few differences that I can point out. One being seasonal availability of fruits and vegetables and second… well no one cared about cholesterol.

I am impressed by your work. I worked with quite a few docs to appreciate what a giant step you took away from the traditional medicine and thinking. Thank you for educating us.

Jack, just spent the last hour or so reading comments. Wow! I'm almost finished reading "Mastering Leptin" by Byron Richards. You two are in very close agreement which is comforting. My question: you made the statement that 4 eggs gets us close to 50 grams of protein. But when I look at the nutritional label on my Barnstar Family Farms Free Range eggs it says that one egg has only 6 grams of protein. Can you explain that? What eggs are you eating? Are you sure they have 12 grams of protein in each? Thanks, Jack.

My eggs are super jumbos and have close to 10-14 gms of protein and I make the rest up with meat. The amount is not important if your cravings and your hunger has gone away. You can tinker with macros if your symptoms are not present to find your optimal protein and fat loads.

Dr. Jack This is my fourth day on the leptin rx i had to up the fat and protein because i am having urges to snack,but now im still having trouble sleeping i wake up alot around 3am, and noticed im gaining weight. clothes fit tighter is this normal through this process? I am 51 yr old female, weigh165,5'4 dieted my whole life and struggled with bulima growing up all my life 🙁 thank you Dr. in advance for your reply.

Dr. Kruse, I just ran across your blog and have found it extremely informative. Great job. I have some big weight to lose, 200+. I also have hypothyroid and take Armour Thyroid. The prescription says to take in the morning and wait one hour before eating. Will this miss up your recommendation of eating a half hour upon waking? Also, could you tell me what you eat in an average day. Thank you.

I am 60 yrs old, morbidly obese (have 100# to lose). After doing Leptin dieting for about 10 weeks per Richards guidelines, all my "old age" aches and pains are gone. I haven't counted protein grams, only calories (about 450-500 per meal), but was doing a paleo diet as I don't get along with grain or starchy veggies. Going by his guidelines I lose about 3# a week.

I had about a month where I just totally fell into carbs again, gained weight and all the aches and old symptoms came back. For 2 weeks now I've been back at the plan and have recovered how I feel and about half the gained weight is gone again.

Decided to give you guidelines a shot, so just switched my counting from calories per meal to counting protein grams at breakfast, then eat small at lunch and dinner, according to appetite.

In general, I sleep well and wake up very refreshed at the same time each morning. Energy has returned. I still have 100# to lose. Could I now be LS and still so over-weight? Can I begin HIIT at this point as long as I don't feel the muscle fatigue you've written about?

Is it normal to breakout in a rash since starting LR RX i am entering my 3rd week and i have a bad rash on neck and other private area's ? What can i do or apply on area's affected? thank you Dr. Kruse for your time.

Greetings. I am delighted to find out about you Dr. K. I was reading some of the blogs on the Atkins site because i started that life style today. My BMI is 41.something, in other words to dang high. I started my day with 3 large eggs, 4 strips of turkey bacon fried in coconut oil and some cheese in the eggs. I had to force myself to eat 5 hours later, to my surprise. I usually eat all day long and into the night. Night is the worst for me. I plan to go with the 50gs of protein first thing in the am, via eggs and meat, or a protein shake depending on my schedule. I look forward to success.

Hello Dr. Kruse, what happens if i binged once during LR I am in my 3rd wk? I notice for dinner I had 1 hamburger patty instead of two and i found myself craving candy, but 2 patties make me stuffed, first time ever since been on LR. Thank You much Dr.

Maria……the answer is yes with qualifications. Some people dont need a nudge of the HPA axis post LR. Some do. Only way to know for sure is wait and see. But if you dont feel well, and the sleep is bad and your stalling on weight loss you need your hormones checked. Most often we find a problem and push the pituitary and it restarts and people cruise right along. It does require a doc to get it going but it is not a hard process to get done.

Thank You Dr. Kruse what test do I need to take so I can take them I recently had alot blood work done and i am post-menopausal <or=27 we're my numbers and my good cholesrol was too high too. I feel good, my sleep getting better,i still awake several times at night but can easily fall back to sleep,and weight loss stalling, Your the Best Doc!!!!

I judge I am Leptin sensitive at least in the liver per your "mirror" test. 6'4" 200lbs. Follow a very low carb diet and LOVE it. Been doing the about 14 months. You mention in one of your posts and or in the Jimmy Moore interview that after one is Leptin sensitive, you can "turn on" you muscles. How does one do that? I am pretty trim ad I look at myself in the mirror, but would like to harden up my body. What recommendations would you have? Is this in a post I may have missed?

I'm so confused about this weight loss subject. I try to follow a low carb woe. The problem is, (at least I think it's the problem) is that when I do well on my plan and I've got my appetite locked up, I don't get hungry and sometimes not AT ALL. Some days I am ravenous but many days I could go all day w/o eating a bite and not get hungry. Just no appetite. So my dilemma is, in one breath fitness gurus say to eat eat eat! "Have to keep that metabolism fired up." Calorie restriction slows down metabolism and do not go below 1000 calories per day. However they also say you need to reduce caloric intake to lose weight. Others say "if you're not hungry, don't eat." Which one is right? If I don't eat will that slow down my metabolism? Should I force myself to eat even if I'm not hungry? What should be my minimum caloric intake as a 5'6 inch female? To eat or not to eat, that is the question. Bypass surgery patients eats very little food, just small amounts very frequently and lose ungodly amounts of weight. I'm not sure if they even reach 1000 calories per day.

@Mz_T I feel your pain. The only way to get on the right track is to test. But I have helped many on this thread. Go take a look. Its over 400 pages long but I have answered many of the questions a newbie will likely have…………. http://www.marksdailyapple.com/forum/thread32345….

Ruth, you have probably long since seen a solution to your friend's dilemma, but I see another solution not mentioned here: meat & eggs for breakfast, coffee without any dairy or with coconut milk instead (yum!).

Thank you so much for this information. It just confirmed most of my suspicions, and somehow I now feel validated. I switched 3 years ago to a gluten free, paleo style diet after being dx with RA. Within a month, of walking and eating properly my pain was virtually gone. I am a nurse, but truly believe in the power of nutrition to heal. My Dr. acted like I was insane for thinking that the food I was eating healed me. I suffered a personal tragedy and strayed away from my routine. This give me the motivation I need to get back to it again, and perhaps get back to being my happy go lucky self. I've also recently read an article about capsaicin and metabolism. I'm curious about your take on adding heat from peppers and it's effect on people who are LR? Thank you again..

@Chris I am not a capsaicin fan for weight loss. I like the use of cold temperature training with weights and sprints for weight loss after you go thru the leptin reset of the leptin RX blog post. Take a look at the Leptin FAQ blog too. Lots of good stuff in the comments section.

Sorry, I think this has been asked before but I was not quite clear on the answer. Currently I eat no breakfast. Do I need to start eating protein in the morning to increase my leptin sensitivity or could I continue fasting in the morning? If I have to eat protein, could you explain in laymans terms what effect that has beyond fasting. Thanks!

I am not overweight, but have struggled with disordered eating for years. I began a pretty strict Primal/Paleo lifestyle about 2 months ago, but still have issues with food cravings and sometimes binges. I started Leptin Reset as an experiment a few days ago and am doing well hunger wise.

I just want to be sure that this is an appropriate protocol for me. I keep reading that it is mostly for overweight or extremely underweight people, of which I am neither. However, I had a bout of serious overtraining where I lost about 10 pounds and stopped getting my period. I haven't had a period now for over 8 months.

Do you think my leptin is off? Will this help?

Since becoming so exhausted from overtraining, I limit myself to walking about an hour a day and doing yoga a couple times a week (also, I'm sticking to this for the LR).

Again, although I am of normal weight, I've never felt normal about food..

@J I think this protocol is ideal for eating disorders. The reason is that most eating disorders focus around the inability of the incretin gut hormones to signal to the leptin neurons in the hypothalamus. The Leptin Rx is designed to fix that very problem. Please keep us in the loop to how you do. Your experience could help many of my readers.

Doctor, I just want to thank you so much for this information. I am reading everything I can find.

I lost 100 pounds over 16 months using the hcg injections and following the very strict diet under my NDoc's supervision, using high protein maintenance breaks after each 40-day round. I am successfully keeping the weight off, coming up on 6 months now. I am looking forward to using this protocol to balance my sleep and pain issues. I am juicing veggies in my Vitamix because I have tmj and can't get enough greens in otherwise. I also take the Budwig FOCC (6tbs cottage cheese and 3tbs flax oil, 2 tbl flax meal) in the morning for anti-inflammatory properties since I have arthritis. My hands are already better after one week of juicing and Budwig. Do you think I should change when I do that or should I add eggs to it and make a smoothie? Would it be ok to just juice veggies for lunch if I'm not hungry after the BAB? I already don't really have hunger or cravings problems.

I am off ALL medications and all my cholesterol, sugar etc numbers are GREAT. I'd maybe do one more round of hcg to lose the last 20 or maybe this would do it for me.

ps, I already only eat low inflammatory fruits/veggies and the little grains I eat are in Ezekiel bread very rarely, and dairy only 2-3x week. I won't have to tweak what I'm doing much at all except timing.

I hope you can shed some light on my question which has to do with the timing of eating and exercise once you are LS. I have read your blogs extensively (here & MDA) but can't find an answer.

I know you say the optimal time to exercise is after dinner at 5pm. But if this is not possible and you have to exercise earlier in the day, should you exercise in a fasted state?? If not is there an optimal time to eat before exercise? Is there an optimal time period to avoid eating post exercise if you are working out earlier in the day?

I have read conflicting opinions on various Paleo sites but none are in a leptin context.

Often the only time available for exercise is around lunch. I've been going in fasted, sometimes have low energy at the end of the session but not hungry, a few hours later I get really hungry.

Seeing as how I've done the reset from LR to LS I'm keen not to go backwards with a poor nutritional timing / exercise protocol.

Thanks for all the information in your blog. You are a generous man! The question I have is how do I manage to get 50g of protien for breakfast when I have an allergy to both eggs and dairy? Eggs cause an almost immediate rash and dairy causes gastrointestinal problems. On the advice of my GP I was allergy tested for these over a year ago and feel much better once they were gone from my diet. I'm trying to eat paleo but it is difficult with these two food groups excluded. I've tried re-introducing small amounts, but reactions to them remain. Any suggestions?

@Joan. I have several patients with this issue. They solve it by eating bacon, and pastured meats from US Wellness meats in am. Others just eat leftover meats for breakfast and one eats boars head genoa salami ( great source of vitamin k2) and liverwurst. There are plenty of options if you open your mind to new avenues.

@Beth In the Amgen synthetic trials is was shown that leptin can induce adipocyte apoptosis so it can kill off the excess cells that are made from IR adipocyte growth.

Here is a quote from an NIH article,

"Leptin, produced in adipose tissue, acts both centrally and peripherally to orchestrate complex metabolic and behavioral changes that increase loss of adipose tissue, including suppressing food intake and increasing thermogenesis. In addition, recent evidence indicates that leptin acts centrally to trigger an apoptotic process resulting in adipocyte deletion. Loss of adipocytes by apoptosis may provide an explanation for the unexpected delay in return to initial energy status following leptin treatments. This review summarizes the major aspects of leptin-induced adipose tissue apoptosis, including some of the newest findings about possible mechanisms of action."

@Jody Leptin declining after starvation (the only natural evolved reason for leptin to decline) helps the body defend against future famines by permanently raising body fatness. This is why so many people regain weight after a diet. It is a built in epigenetic modification to our biology.

Thanks for your reply re the 50g protien at breakfast. I don't always manage it, but I'm getting there. I would like to ask you if you think PQQ would be of help with an essential tremor. I have had this since early childhood in my hands and only lately learned it was hereditary and degenerative. I have never taken medication for it. There are times it seems to be getting worse & sometimes I'll have it in my jaw when really tired. I'm wondering if PQQ would slow it's progression.

I love this site, I cannot stop reading it. I feel like someone finally "gets" it. I was overweight until age 30 and my weight maxed out at 185. I am 5'3". I am now almost 39 and have maintained a weight of around 125-130 since then by cutting carbs and doing a lot of running, body weight dependent exercises and kettlebells. I eat mostly Paleo – but after reading all of your information, I am going to get a lot more serious. I am finally starting to understand and believe why "chronic cardio" is bad… and am now only running 3 miles or so every other day. I am wondering if you think I could still be leptin resistant at 128 lbs? I gain weight very easily and feel compelled to restrict food because I worry I will gain. I only have a "cheat" maybe once per month, but pay dearly. I think I am around 20% BF – but would like to drop some fat and nothing seems to change with the way I look in the mirror – even with all my lowcarbing/exercise. I guess more than anything I would like to stop worrying about weight gain, or losing what I have achieved. I recently earned my masters in Exercise Physiology and I am completely fascinated by biochemistry and nutrition. Wish I'd known about your blog back then, it would have helped me through biochem:)

@melissa. Thanks for the nice words. I doubt your LR but i bet your hormones are trashed because of the chronic cardio. If you want body comp look at my latest blog post and keep reading my leptin blog posts. It controls every hormone that makes you look like you want. If you run like a runner you look like a runner and i never want to look like an endurance runner. A sprinter is more to my liking.

My brother recommended I would like this web site. He was for once totally right. This blog actually made my day. You can not imagine just how much time I had spent looking for this information! Thank you!

what are your recommendations for a packable breakfast to take to work? i get up and leave for work quite early and have been taking yogurt or warm raw milk with me, but that's nowhere near the amount of protein you're recommending! also, do your recommendations vary based on height and age (i'm 5'2" and 55, 40 lbs overwt.)?

@susan V I work about 90 hours a week so I am pretty busy. I usually drop grass fed meat into my crock pot at bedtime and pour a bottle of wine with bone broth I make over it and cook it for 8 hrs while I sleep. When I wake…..breakfast. I also make smoothies for the go, and I eat liverwurst, salami and leftovers in ziploc bags. On the weekend I make ridiculous creations. I cook a ton on the weekends so I have plenty of treats during the week. I am quite kitchen efficient and got that way because I had to with my job.

A little history: 3 years ago I was 24 years old, female and 175lbs. Over the course of 12 months I lost a lot of weight (55 lbs) through restricted calories/vegetarianism (starvation)/excessive exercise etc. My father died during this time and the grief added to the stress I was already putting my body through. I became hormonally buggered (lost period/hair loss/depression/no libido etc), but was at my ideal weight at least (!). I maintained my new low weight through calorie restriction/vegetarianism and cardio (running) for a couple of years until I found paleo this year and saw the light. Have been paleo for 6 months and have seen amazing health benefits without weight gain. I am now trying to tackle my hormones as I am still suffering from amenorrhea/hair loss (2 years without periods).

This is where you come in. I found your leptin reset as I was researching the amazing effects of leptin on people suffering with hypothalamic amenorrhea, and worked out that my weight loss process more than definitely destroyed my leptin sensitivity and lowered my leptin levels. I now follow your leptin reset protocol (and love that I no longer graze during the day to stave off constant hunger even though I eat enough fat/protein since going paleo) – my stats are 5ft 7", 128 lbs, 23% bodyfat, eating 60-80g protein, 110g fat, 75-100g carbs per day (15% protein / 65% fat / 20% carb). I have been doing the reset for 3 weeks, but after learning that you need carbs to raise your leptin levels, I have upped my carbs from low (30-40g per day) to higher (75-100g) from sweet potato/beets etc. I wanted to ask you opinion regarding how to work carbs into my day as I know I shouldn't be eating high carbs in the morning, and also not with a high fat meal – so currently I eat most of my protein & fat in the morning with no carbs, within 30 mins of waking, then I have a medium protein/low fat/higher carb lunch and dinner (I find that my need for protein by dinnertime is minimal due to the better leptin sensitivity). I do very minimal exercise (a little walking and yoga) and find that I no longer need to work out to maintain my weight.

Maybe a little too much info 😉 but after 2 years of a very inactive sex life with my partner, I have made it a priority to focus more on this for the hormonal boost (oxytocin etc) and am getting at least 8 hours of sleep a night which is helping things also.

Is this the optimal meal/macro make up for a recovery from hypothalamic amenorrhea/hormonal imbalance for someone that has messed their sensitivity/levels up through a drastic diet/exercise regime? Do you have any other suggestions to optimize my road to recovery? Should I be eating more carbs, or eating them at a specific time of day? Etc etc…

Any help or advise you could give would be the lifeline I'm looking for. I just want to get my hormones back on track.

@Nudge I have had good luck with patients with HA with high protein diets first. If that fails the I use carbs to restart the hypothalamus if that falters then you have to tinker a bit with hormone modulation with the endocrinologist. I think what you have found is working and you are doing it correctly. HA takes time to get back to optimal. And yur cortisol spike likely had a lot to do with why your reset took so long. Keep doing it……and soon I will be posting what to do after a reset has been successful. I think many people want to know what to do after the reset period ends. It's coming I promise.

Thank you for the reassurance Jack. Based on my body stats – how much protein would you recommend seeing as I dont do much in the way of exercise to warrent too much. Is 70g too little for 128 lbs? I found when I've experimented with higher levels I have started to bulk up a little which isnt what i want. Are my carb levels optimal also, and I a right for keeping them for lunch and dinner with lower fat than breakfast?

@Nudge it depends upon your hunger or cravings really. If you have none and are eating with good timing I would be OK with that level but you can titrate it up or down based upon this variable. I also would suggest to you that you think about using BCCA's for your protein source too. It has amazing effects on many female athletes who have HA.

OK, I found it so nevermind about the HCG supplements. Your info is amazing. Thank you so much for all of this hard work.

I still would like you ideas on the sugar in the meats….. 😉

I also have a neurological question. (Seems so odd to post it here though!) I suffer from Basilar migraines and would love any info you have about them and if there are things that I can do to avoid them. I have had them for about 20 years now. They are fairly infrequent but me falling down is becoming a bit more regular vs. a quick dizziness and the last couple episodes of imbalance were lasting almost 24hours.

The headache itself is usually the next day and comes with a flasher and leaves when I sleep or if I take Ibuprofen before the flasher grows out of my sight. It starts as a little spot in the center and opens up into a crescent shape as it moves outward. It usually takes 20 min before the pain starts.

Could they be hormone related or sugar? Are there things that I can do to avoid them? I haven't seen a neurologist in 20 years and have just dealt with it. But I am beginning to wonder if they are related somehow to being way out of whack for so long.

I am not opposed to a private email about this if you would prefer, just respecting the integrity of the thread.

@April basilar migraines are often due to high omega six content in the brain, usually glucose metabolism issues in the brainstem and very low levels of Magnesium in the brain. Any kind of stressor exacerbates them and increases the auras on gets. I will tell you the biggest triggers I see are wheat, grains, nightshade vegetables, and dairy products in the diet. I am also not a fan of conventional treatment for them because they don't get to the underlying source of the problem. Excessive inflammation from high omega six levels. You should consider moving to a paleolithic diet (See Robb Wolf or Mark Sisson or Art DeVany's books) that is ketogenic in nature and up you Magnesium levels for quite some time. Turnover in the brain is slower than it is in the somatic cells so it will take some time to reverse this. You should consider getting a 06/3 ratio, DHEA, progesterone and pregnenolone level all done too with your doc. This likely will show a pretty interesting picture. Often young women with basilar migraines have horrible menstrual cramps too……..why? Omega six excess.

Wow, I am kinda in awe and taking that to heart. It make sense. I have been eating a very strict paleo/P3(HCG) style for a bit because of my weight and the last episode was after a wheat/sugar/nut binge about a month ago. I tried to incorporate them again into my daily diet and I had some very strange reactions…. I already feel so much better now switching to the reset.

This totally makes sense! I don't have any insurance and we are very broke… so I will take what I can of that fantastic info and make the most of it until I can see a doc again. Thank you, thank you, thank you! Finally something other than very vague food restrictions and drugs.

At 134' 5' 3", I started this in September. Dropped down to 130, but more amazingly I lost a whole pants size with so little weight loss! And, I have girl curves, lost the bloated look, sleep 7 hours solid and wake up on my own. Cut back workouts to 2 LHT and 2 HIIT per week, all equal 2 hours total. I feel and look amazing at age 45. My issue is still blood pressure. Without medication it runs around 145 over 90. How can I fix this for good???

Thank you for the great info! This is my first week of LR. I'm feeling really good except for my frequent heartburn that I did not have before. Could it be because I don't have a gall bladder? Should I be eating less fat or taking some supplements for eliminating the heartburn? I can suck it up but if I get a rid of it, I'll be in heaven.

@Mart heartburn is likely from a reflux issue. I bet its an omega six excess issue causing your Lower esophageal sphincter to open and acid to pour in your esophagus. I would look into betaine HCL acid and checking your B12 levels. I also would bet your Homocysteine is up and your body comp is down. Check it out with your doc.

Got the betain HCL and B12 supplements and looking for a sn open minded doctor who would run more tests than the usual blood panel. I also heard that apple cider vinegar is good for a reflux issue. Is it an overkill to combine it with HCL?

I have been on a low carb diet for over 2 months and lost only 2 pounds. I am 148lbs at 5'4" – 15lbs gain in two years. Not good.

My light went finally on! I see the brain gut connection! You are right, I have bad gut. Not only the reflux (the gallbladder issue) but 5 months ago, I finish a third treatment for h pylori. Two previous ones with Prevacid were unsuccessful. The third one – quadruple therapy killed it. It probably was not that great for the overall digestion. Thank you!

@Mart…….you have seen how the QUILT is designed to work. Everything is interconnect web in our biology. The more times you see the same issue from a different optic the closer you get to seeing the real object of your desire from a view point that brings it into focus. Im glad to help you. Pay it forward!

Yes, I am working on another bad gut :-). My husband got Crohn's since his teenage years. He had a resection of ileum 24 yrs ago. For that reason he is on Cholestyramine (otherwise constant bad diarrhea) and B12 injections for life. He had bad flare ups until he went on a cocktail of Ultra primal defense from Garden of Life and grass wheat 15 yrs ago. He still gets flare ups of his fistula but not often, so there is still a level of inflammation in his body. He started low carbs with me two months ago. He feels great and lost 20 lbs (I;m jealous). Now, I am getting him on your protocol with all the suggested supplements. He just mentioned to me that he had unusual diarrhea – like something was cleaning out of him. Did not know what to think of that.

Is there anything else he should be doing Crohn's wise?

Doctor, you are brilliant and I just want you to know that I like others am so grateful to you. It must be incredible knowing that you are making such a big difference in so many lives. When it really takes of, it will be massive and profound. You found your calling, you must be a very happy man. Thank you.

I think it is the first one. He tolerates fats very well including coconut oil. The only change he had in last week is the addition of the suggested supplements. As I was reading your blog comments about magnesium malate being a bit laxative, I thought that might be it since it was just introduced. I will try to give him magnesium oxi instead and see. If that is true, we will reintroduce the mag. malate in smaller dosage and will go up from there.

My husband told me last night that he feels that his thinking is much sharper and his thoughts are very clear. He's always been a deep thinker so he values this more than anything. I was so happy for him. Thank you.

Ever since I was young Ive had a weight problem. Even the past 12 years, where I have been a competitive swimmer and water polo player and train between 2-4 hours a day, and eating very low carb and high protein I could never lose weight. I eat a few low- sugar fruit, but mostly veggies, meat, eggs, and am very keen on nutrition. I'm 22, have been a college athlete for the past 3.5 years and just got diagnosed with hypothyroidsm about 3 months ago. My doctor started me on armourthyroid and prescribed 2 rounds of the hcg diet, where I lost 30 lbs. The weight no matter how I try has been trying to come back however and its been incredibly frustrated. I read your research and was just wondering if you think I am leptin resistant, even if Ive basically eaten paleo the past 2 years. Not a gram of sugar, and barely any carbs, the worst was an occasional bowl of oatmeal but ive cut that out as well for the psat 3 months. Please tell me your thoughts about my situation. Ill try the 50 grams of protein 30 mins after taking my armourthyroid pill in the morning, and keeping meals 2-3 times a day like i have been. Im 5'7, 140 lb now (but used to be 170+ even with eating superbly and rigorous exercise) , and a 22 female. I know Im not unsulin resistant, my cortisol is prety normal, and a blood food intolerance test was also taken from me, and I try to work around foods it doesnt allow. Any thoughts would be appreciated, and if you 6 week protocol would help, even if its not a huge shift from how Im living life now. Thanks you dearly

Very many thanks for this site/blog. What an insightful read. I am inspired to give the protein breakfast another go and can see the protein shakes I have been having r only causing more issues. Since being on them I seem to get cysts and eruptions and I've thought this to b a symptom of the build up of the shakes over 2-3 years so hoping the protein will clear the system a bit better. Also with lack of sleep I was tested and found to b lacking in VitE so when I took 1000ul before going to bed I slept the whole night thru. Can u provide a reason why this might happen. Many thanks

I have a few questions. I have Lupus and I have slow onset T1, (33 years) and have promoted low carb for a long time. I wear an insulin pump and I wonder if this changes the game plan? I'm just over the line of "obese", have little energy, feel hypothyroid (despot multiple "normal" tests, and can't tolerate heat at all. I'm rarely hungry more than a couple of times a day, so I probably have 2.5 meals a day. I abhor exercise because my muscles hurt but I do love to swim. I find it hard on a budget to purchase grain-fed meat and everyone where I live in Australia, is still stuck on "the big fat lie" there's almost no meat available with an ounce of fat on it, let alone grain fed, which is hellishly expensive if you can find it. To add into the mix, super high cholesterol for as long as it's been tested (I refuse to take statins) and I worry about APOE-4, which I can't seem to get tested for here. My doctor has an apoplexy when I tell him I eat 2 eggs for breakfast (I eat 3 plus bacon when I have it) and the argument ensues about statins, so I only go to him to get insulin scripts, otherwise it's a waste of time. No matter what I try, I can't seem to shift the weight and I'm wondering if it's because my body is saturated with artificial rubbish insulin 24/7. Everyone produces insulin even if they're not eating, but what's the deal for people with Type 1 on a pump who do low-carb and the weight doesn't shift? I'm gaining about 3kg a year! My A1C is around 6.5%, currently with few hypos (maybe 1 a week). Having given up, my eating is a bit crap at the moment, but getting back to what I believe should work but with no results also doesn't wash well. What light can you shed on my situation?

Thought I was doing Paleo/low carb. Under 50g CHO a day is ketogenic. Or have I got this all wrong? Been following first Atkins, then Sisson, Taubes and Bernstein (diabetes) etc for years and thought I'd learned what to do better than most. I could lose weight easily when I still had a partially functioning pancreas. Now not, hence my question about insulin pumps.

@Sooz You might be but you need to move to using MCT oils and coconut oils to a great degree to treat the diabetes. You also should consider high dose D3 and K2 increasing magnesium levels orally and utilize epsom salt baths twice a week. I also would have you cut dairy until your FBG is below 88. This alerts you that leptin has regained controlled the master switch of liver's enzyme that controls gluconeogenesis (PEPCK)

@Jack, thanks for the advice. I use coconut oil quite a bit, and live in sub-tropical area where sunshine is in abundance but my levels may not be optimal. How do these oils help dead beta cells? Or do you mean "treat" the result of having Type 1 Diabetes where beta cells are destroyed by GAD antibodies (which I will swear was delayed considerably by doing low carb). MY FBG at 88 (4.89 mmol/L)? Could risk a night hypo to get there, but at slightly higher 93.6 -99 (5.2-5.5) this is success for me in trying to treat Dawn Phenomenon. An insulin pump is wonderful but not perfect. Neither is Type 1 Diabetes. I'm currently increasing insulin for Summer, when I need more (unlike some who need less). I suspect the heat stresses me, so maybe the magnesium will help that too. If I cut dairy, being post menopausal, do I need to worry about bone density or is that all hype too? Thank you so much for your responses!

Hi Dr. Jack: i was wondering if you might be able to assist me/my doc with this issue. I am 50, went into menopause @ 48, dx hashimotos '04. Before MP I could stay thin and everthing was low except the estrogen. Now I have all these weird reactions to adding the needed hormones (don't make any) like gaining weight and foggy thinking. DHEA, Pregnenalone all low, estrogen extremely, yet when I try to up it gain weight (recently added more thyroid) have gut issues that only seem to better with hormones, but if one is off, it messes it all up. My doc is well know to celebs in Beverly hills and he is fully committed to finding why I have paradoxical responses, but he said himself he just knows hormones. We need help and I saw your blog. Should I call your office to discuss? Thank you.

I want to add my voice to the heartfelt THANK YOUs here! What an awesome devotion and service you are providing. Most of us would have no resource without you. Bless you.

I've got multiple issues … most of them incompatible with each other, alas.

I'm in desperate need of weight loss! I've lost 150+, but that's only about half of what I think I need to lose. I'm 5'3" and stuck at about 240. It's been a long road, and I'm *sick of it*!!! LOL I want to get to my target forthwith. I've accomplished what I have through efforts of an endocrinologist who's put me on his diabetics' diet. It feared me at first, because it looked so very imbalanced. Well, I suppose it is … but it's been working; I can't quibble with that. He wants me on a NO-carb, hi-protein diet. I suppose that's what led me to you, trying to research the underlying intent. It looks like it's a solid perspective, and I'm going to try to adhere better than I've been doing.

My "other issues" confound the problem, though. I also have scleroderma, with the associated GERD (I never feel any reflux, BTW… but I've had upper GI endoscopies and stretching which evidence a lot of erosion in my distal esophagus, so I suppose I do have reflux even if I don't feel it). The endoscopy results show a fairly significant stricture (stretched 3X now, and coming back again) with a hiatal hernia. These three things make food in general a difficulty. Protein in particular aggravates it, and sometimes one bite can irritate the stricture to the point of spasm and then I can't even get water down. Some days are great, others I'm out of luck.

I believe I'm stuck in my weight reduction scheme at the moment primarily because when I'm hit with the esophageal spasm, the only thing I can (sometimes) tolerate are carbs. 🙁 This is a Wrong Thing, as I am very well aware. I don't know how to get around it. When I CAN eat, I can stay better on the plan. But there's some days I just can't … and those days may be once a week, or more, or less… I have to begin carefully when I first get up to not "start something" with my GI tract. I never know how (or if) it's going to cooperate with me. Oddly enough, I would think salads, et al, would make the situation worse. But usually I can get through salads okay. I am confused by this.

I am also one of those very rare individuals who are "night owls" by nature. I know this goes against all sensibility. But I converted to the schedule nearly instantaneously and lived at it for over 30 years now. Even though I'm retired, it's still "natural" for me to keep bizarre hours. I never knew other people didn't actually struggle and suffer every morning as I always did. My cycle is shifted about 6 hrs+ from everyone else's, it seems. Despite that, I believe I can adapt this diet to "my normal", so long as you don't see that as being completely counterproductive.

I would just like your thoughts and suggestions on how I can approach it with my other GI problems? I'm pretty much okay with eating as much protein and bacon and fats as my constitution will permit. But what do I do on the days it won't? I am a lifelong carb addict, and I'm eager to shed that. Even though I think I will never stop craving rice. :,(

Thank you again for being a lifeline and hope to so many. You're the best.

@exotec scleroderma and esophagitis are both tied to a leaky gut. you absolutely need to eliminate all nightshades, rice, and dairy, grains and legumes to get this right. not even one bit should touch your mouth ever. you really need to read Cordain's new book the Paleo Answer.

Hi Dr. Jack – Last time you were on Jimmy Moore's podcast, you were good enough to answer a question from me about why it's advantageous to exercise after 5PM if you're still LR. I know I'm still LR by looking in the mirror, but I'm way better off than I was a year ago at this time. I'm turning 48 tomorrow. Body fat is down, eating less frequently (3-4 times a day), but still struggling with some hunger that I think will get better over time. And that brings me to a second question I wish I had submitted to Jimmy to ask, but I'll ask it here: On Saturday mornings, I take a brisk walk anywhere from 45 mins to 75-90 mins with a good friend. Barring precipitation or ice, we're outside no matter what the temperature (it was 33 degrees when we walked this morning!). When I work out in the evenings, it's at the gym with a personal trainer or a kickboxing DVD at home, pretty rigorous for only about 30 minutes, and I'm never hungry afterwards. (As a side note, I know I shouldn't do rigorous exercise when I'm LR because of long-term effect on stem cells, but I also work an extremely stressful job, and it's how I cope with stress.) But after an hour or more of walking on Saturday mornings, I'm climbing-the-walls hungry all day long, which ends up wreaking havoc with my eating, both in terms of what I'm eating and the timing of it. I can't go more than 2 hours without eating after these walks. I've tried a few different approaches to eating before the walks, not eating, what I should eat afterwards, etc., but nothing seems to help. I'm kind of desperate because the only way I seem to be able to eat paleo and time my meals properly on the weekends is by skipping the walks, and I really value the social aspect of them. Do you have any suggestions, and/or could you explain what may be going on with my hunger on these days, when I don't find myself hungry after I do a later, more rigorous, shorter workout? Thank you!

@Laura…….you my dear have hit on Factor X. I cant answer it here because I am planning it for my book or Jimmy's cruise but if you email me and sign in your email you will not release the info publicly until after I do I will tell you……but no details around how I figured it out.

Would the Leptin Rx help someone with RA? I have had RA since my teens. I've been gluten & dairy free for over 2 years. I have been following a strict paleo diet for peeps with AI issues (aka Robb Wolf/Loren Cordain) for over 6 months. I'm working with a ND and have too many lab results to list them all, but here are some of the ones you hit on frequently…. we have found some gut dysbiosis and are working to correct it. Also found low salivary cortisol (but normal curve), low salivary DHEA, lowish TSH with the rest normal except for rT3 which is high. Vit D is over 60 ng/mL. CRP (not hsCRP) is very low. I have good blood sugar control. E and P (via blood) on the high side of normal. Past history of girl issues (PCOS, fibrocystic breasts, menstrual issues). Always been athletically thin.

I feel significantly better on Paleo, but still have joint swelling and pain frequently with soft tissue impingement. I also still have food sensitivites. I'm exhausted all the time. I must be missing something because Paleo works like a charm for some folks with RA (or so I read).

@Loring…….yes it would but there is some more info for you that will be in my book. Patients with AI diseases must be checked for intracellular glutathione deficiency as the source of the continuing gut issue. If present its got to be agressively treated. The more severe the AI the more severe the glutathione def to expect.

Dr. Jack – I emailed you as you instructed; the only address I could locate on your site was info@jackkruse.com. I hope you're able to get that. Thanks again for all you do, both here and on Facebook. Do you have an ETA on your book?

I've been researching for my fibromyalgia for a while now, and this is the first time that I have seen leptin and fibro linked. When I was first diagnosed, I was slightly overweight. I was "fine" one week, but then over a couple of weeks following, I got a "double-whammy" of some sort of virus/infection one after another, and was knocked out for months after with fibro & IBS (and apparently massive reactions to food — IGG antibodies to 34 different foods… so probably leaky gut as well). I am now at a normal weight due to the allergy restriction/rotation diet and have been able to get back on my feet again with minimal pain most of the time (though still some fatigue and less endurance than others my age… but I am mostly well as long as I don't "overdo" anything). Is it possible that infection could push things over the edge if your biochemistry is already off? If fibro is related to leptin resistence, do you think that it can be completely reversed over time? Thanks for writing in detail… I've been trying to uncover the "why" for a while. Fibro, immune issues and food allergies seem to run in the family, and we all are working hard to get better… but it's hard to fight without knowing what the body needs…

Ah… it seems like so many diseases tie back to inflammation at a base level. Thank you. I have a pile of notes from reading over the past year, and I will look more into leptin and inflammation and see how to it ties into what's going on… The posts are helping me to understand a lot more than before…

I am 55 and weigh 225 I have been on a low carb, Low fat, Low calorie approx 500 – 800 per day diet since last Jan.. I have lost nearly 50 lbs but for some unknown reason I have stopped losing and actually began to gain.. It is very frustrating.. I refuse to exercise as I will gain up to 5 lbs overnite.. Have I ruined my metabolism and can this diet also help me. I tried the high protein AM yesterday but it put my calories way up there and I went up 1 lb this morning.. So needless to say I am terrified that I will only gain?? Can you tell me what I need to do to lose again and turn my system around and when will it begin to go down?? I use to have muscles and joint pains so bad I could hardly walk.. I am better now since I have been on the LC plan…..

@Sandi You won't like my answer. Since you lost the weight in an incongruent fashion to how how our leptin receptor works your brain will make you regain it because you have invoked the famine epigenetic program in our DNA that is hardwired into us. You need to do the Leptin reset and you will gain weight until you have rewired and activated the program to lose the weight as we are designed too. Make sure you buy an paleo 1.0 book and marry it to the Letin Rx blog post. If you want to see how this works come on over to the thread in the nutrition forum at http://www.mardsdailyapple.com and read about what to expect. There is a 1500 page thread with tons of unreal info for free with lots of people who have successfully navigated the Leptin Rx now.

Thanks so much for your time and effort. This stuff is transformative.

I have been eating Paleo and doing HIIT, weightlifting and long walks on a 3-day rotation. When I started, I was abuot 255 lbs. Now I'm down to 225 lbs. but have plateaued.

I started low-carb Paleo because I was diagnosed as a reactive hypoglycemic. I would eat and get horrible fatigue, vision disturbances and headaches. The first 6-8 weeks were great and I gained energy and things were going well. But as I added some cheat days and more consistent Paleo carbs back into my diet, things started going south.

Now I'm stuck at 225 lbs. and have been getting awful hypoglycemic symptoms again. My questions are as follows:

1. Once you damage you metabolism as I surely have, is there no going back? Will even cheat days cause a return to insulin and leptin resistance?

Dr. Kruse, I am one year away from going to college to play basketball and have struggled with my weight my whole life. In the past year I found paleo and crossfit and have lost over 30 pounds which significantly helped my basketball game, but seem to be in a stand still for the last 20 or so pounds.

I have just recently started upping my protein intake and I usually stay around 50 grams or less of carbs a day with no sugar, fruit, or nuts. I am about 100% compliant except for some dark chocolate and nut butters once every 2 months.

I am desperate to lose the last bit of weight so I can truly see how great of an athlete I can be without the extra weight on me but I am not sure what to do as I can't stop exercising or going through tough basketball workouts to be fully compliant with the LR protocol.

Do you have any suggestions for someone like me who is unable to stop exercising.

Dr Kruse, I have an 11 yr old that is obese. I have put her on several doctor diets and she gains weight with them. I suggested a diet like Atkins or South Beach and they told me absolutely NO. Will this harm her? I know I am leptin resistant and have used South Beach to lose 50 pounds, still need to lose another 20. Getting back to my daughter, I suggested several things to her doc and I am always told she just needs to stop eating so much. She does not eat a lot, maybe 1000-1200 calories. and during the summer she exercises regularly and takes Karate. I am tired of fighting with her pediatrician. HELP PLEASE

@Kelly both my kids were obese…….my son began at 15.5 yrs old. he is now 18 in college. 260 to 190 at 6'3. A rockstar. My 10 yr old started off late because she did not believe it would……one yr she has been paleo on the Leptin Rx like her brother……she has lost 20 lbs and is on her way to optimal, Buy a paleo 1.0 book and marry the concept to the Leptin Rx blog post to it. You wont be able to have the kids use the same protein levels but you will figure out what they can eat. And just feed them. My kids love this. I made them fat and now I cured them like I cured myself.

Thank you so much for all your work,when its all said and done, you will likely have saved more lives here than on your surgical table.

Two questions for you. Im 48 , 5'8 and 215lbs.

First has to do with an addiction to Aspartame. Two decades of abuse and addiction with this toxin. I dont have any energy without it, Ive gone cold turkey several times, for up to six months, but never feel that well or energetic. I suspect strongly that this, in addition to being horrible for me, has also added to my leptin resistance. In your experience will the leptin reset protocol help regain proper energy levels and if so how long to regain feeling good? Ill save the second question for another time.

@Derrick you maybe shocked to know you and I had the same problem. At my height I drank 4 2L of diet coke per day from close to 20 yrs. IF I could break it so can you. It was the hardest part of my recovery honestly. I did it by going first to flavored waters with artificial sweeteners then I moved to seltzer water with natural flavors…….then I moved to regualr water and green and black tea that was home brewed. It took me three yrs. It was well worth it. I knew I was going to have some issues doing it so this is when I got serious about transcendental meditation and biofeedback. It was s mashing success. I have some patients who have used accupuncture to do it too.

Im glad to know Im in good company. I started with Diet Coke and then tried some of the "harder stuff". Im pretty sure Dt Dew has meth in it. OK meant to be funny but I work in the mental unit for our states prison system and have seen my share of addicts getting stuff out of their system and this aspartame business is no different and no joke.

It appears our strategies are in sync as well. Ive discovered seltzer water and use fresh lemon juice in it.Pretty good substitute I think.

Also Ive started doing The Tibetan Five Rites in the a.m. again. I believe they are very beneficial at getting the endocrine system going and also and perhaps as important they open up blockages in my energy system. Also doing some Taoist standing meditation in the afternoon.

My big concern is that doing the reset and kicking the aspartame at the same time may be too much. Ive started replacing the Dt Dew with seltzer and currently eating three meals spaced well apart ala carbohydrate addicts diet. Two low carb meals and dinner with a reasonable portion of whatever preceded by a salad.It may not be ideal but i can live with it until Im feeling better. Ive had good luck with CAD in the past but after doing a three year stint on third shift I suspect Ive further damaged my leptin sensitivity.On first shift for three years now but I still feel the effects in sleep patterns etc.

@Jennifer No counting calories is an epic was of time and causes worry and anxiety that raise cortisol. Read my thought of today on twitter about this very issue or read the response I just made to Ben G on the comments section of the Leptin Rx comment 704

Dr. Jack. I have been doing your leptin reset program for two weeks. My problem is that I usually wake at between three and four am every night and can take about 15-30 minutes to fall back asleep. I have no problem eating 50g of protein when I wake but will this sleep interuption keep my leptin from reseting. I have been eating paleo for six months and lost about 30 lbs however I am currently stalled with about 20lbs left to lose. I should tell you I am diabetic and have had heart bypass sugery. when I went paleo I weaned myself off the sixty units of lantus I was taking and my sugar reading stayed around 140-160. about where they were when on the lantus. Thanks for your great website. Chico

@Chico ask your doc to get your DHEA-s checked and free and total Testosterone with a vitamin D level. I bet you will find all are bad and the source of the sleep issue. You can not lose weight with bad sleep. It is biologically impossible unless you have anorexia.

Thanks for the info Dr. Jack. I will have these tests done. Should I stop the leptin reset program until I do? Am I wasting my time? I should note I am 56 years old and have had this sleep issue since childhood. I think it's become more a habit than anything else. I was prescribed androgel for low testosterone but an md who is a personal friend told me it was not the best thing for me with my heart history.

Thanks very much for the reply and I agree wholeheartedly with the calorie counting trap! I ask only because after having been very compliant with diet, not considering calories and losing about 15 pounds I seem to be rapidly gaining it back, having changed nothing in my routine. I've been tested as highly hypometabolic (BMR 1050 for a 215 pound woman) and obviously am leptin resistant so I'm curious how or if calories play in? At my weight losing weight shouldn't be that hard if eating a clean diet, which I've done now for months. Do I just need to wait longer for my liver to respond? Grateful for advice. No doctor thus far has had anything helpful to say…

Hi,Doctor Jack, tomorrow will be the end of the 3rd week on the leptin reset for my husband and I…we are sleeping better, less aches and pains, my asthma hasn't flared but twice, we are both not tempted by non paleo foods, and I have lost 20 pounds ( I was over 300 to start with) and my husband has lost 10 pounds ( He was 250).

I just have a few quick questions. Where is the best place to get betaine HCL.. GNC locally didn't have it.

Also, I was trying to use up vitamins and supplements I already have, and nearly every one of them has at least got rice flour. Do you know any brand that doesn't, or should I not worry and ignore the negligible amt.

I have been recommending your blogs to most of my patients with inflammatory skin disorders (almost 90%)

since I started this. I know it will help them because I have rosacea, adult acne, and eczema, all of which are vastly improved. However, you should see most of their faces when I suggest cutting out wheat and dairy.

Sigh. Oh well, at least a few will go to your web site and see for themselves.

Thanks again for all you are doing. You really are saving lives everyday just by blogging, in addition to all you save in the OR.

@ derm Deb I generally tell patients to source it online. If you go to the MDA site you will find experts on online shopping. They are better than me at this. Dex and Jan and colleen buy everythign on line and get killer deals.

First, Dr. K, thank you so much for providing all of the information that you do! I am not quite through reading the monster thread on MDA, but I just have one question and that is, even if I am not LR, will doing a leptin reset harm anything? It can only do good, right? I know my circadian rythms are off and I have horrible sugar cravings, so I do want to get my hormones checked, but I just thought it would be a good idea to just try this in the meantime until I get labs done.

I am 5'2" and 118 lbs (female – 43 years old) and have lost about 30 lbs in the last year with Paleo and SuperSlow once per week (plus I walk about 2.5 miles a few times per week to relax). Through vitamins, I am correcting a failing adrenal gland that caused me to have a slow metabolism, but now has gone the other direction to be a mixed/fast metabolism. I am still struggling with losing fat around my mid-section.

I was just diagnosed with Type 2 diabetes and that is where my question is. My fasting BG is anywhere between 71 and 104, but when I ate a a plain bagel to do a self administered glucose test, in 1 hour my BG was over 250. I repeated this test another day to see if it happened again and it did.

Do you think the Leptin reset will fix the diabetes (everyone in my family is diabetice except my younger sister)? Today, after eating my usual breakfast of raw eggs and coconut oil (FBG 81), my BG was 99 after 2.5 hours. On other days, it has been 88 after 2 hours (90 FBG).

I have started taking Berberine HCI, Biotin with Chromium, and CLA. When I am doing the Leptin reset, should I continue taking these during the reset period?

Finally, I usually fast 24 hours 1 day per week. Should I stop doing that or continue until the Leptin reset is complete?

@Dulcey THe Leptin RX reset using a Paleo 1.0 book is the Primal Rx for greatness for a T2D. When you use the word cure I cringe. Because as you find out in my Paleo Summit presentation…….Diabetes is not a disease to me……..it is part of our evolutionary design. The key to activating its metabolic pathways are following the Leptin Rx reset and using a ketogenic paleolithic diet. You can register for the Paleo summit on my site at the top right. I hope you enjoy it! My talk will be on Feb 27th, 2012 with Sean Croxton

What about those of us who are taking thyroid hormone and aren't supposed to eat for an hr after taking it? I don't quite go an hour, but try not to eat for half an hour after taking xymogen t-150. I do eat a full-on protein breakfast shortly after that, 45 min or so. I'm really interested in learning about the reverse t-3 stuff, too, just trying to wrap my head around it now.

So if someone is very very thin, then you'd recommend them eating carbohydrates to get their weight up? Have you ever heard of the book, Life Without Bread, in which they discuss the very thin carbohydrate eater, defining them as people who burn the excess energy from overeating of carbs, instead of storing it….

And the authors of the book say that one should not eat carbs if one has a low weight issue. In fact, they should do the opposite and consume more and more fat.

What does it mean when a person tries to shift to 3 meals a day and they have major signs of hypoglycemia like anxiety,jitteriness,light headed ness. Should they just continue on the 3 meal diet plan and adjust the fat content of the diet. The only solution for this I've heard in the past is eat protein every two hours

I recently found your site and thank you so much for all the information and feedback. I am a 43, 5'3" and now 211 pounds. I have been reading all I can on your site for about 2 weeks now, however on February 11th I started my first round of HCG after a lot of research and personal deliberation, but I was desperate as nothing else had been working for me and my quality of life was decreasing at a fast rate. HCG I will say has been successful as I weighed 237 on the day I started. I am taking all the supplements you suggest, but the million dollar question is am I hurting myself in the long run. I have lost 26 pounds and still have 20 days left in this round. The plan has been to move right into your Leptin Rx. I truly thought the HCG was a way to reset my hormones and everything else would fall into place, but now I wonder. If you were me, what would you do? I am looking for a better quality of life over huge weight loss in a short period of time.

@Irisma Change and eat what is best for your biology. Go watch CJ Hunt’s documentary. After your ready go buy the The Paleo Answer by Loren Cordain and come back here when youre ready for optimal. When the student in you shows up the teacher in my will arrive. But I am not going to force you to change your mind. You need to come to that realization and being a vegetarian has no basis in our evolutionary history. That is why vegetarians do terrible as they age. Their dogma hides the results……but southern India has lived this way now for 500 yrs and the result so that experiment should open any blind eyes to the biologic affects of those neolithic beliefs.

I don’t mean to be lazy in my question but I have been researching for the past couple years and I am getting tired. I was 39 when I was diagnosed with Early Onset Parkinson’s. I am now 54. I only recently found out via my own research about magnesium. Then I read about adrenal fatigue and then today I read about LS.
I am over weight and tired. I just want to know where to start. I have been soaking in Epsom salt baths for a month… but I feel I have jumped into the middle and not the beginning. I don’t feel that doctors care about my health, just about helping my symptoms. I need to help myself. Where do I start. I don’t exercise and I am 90 lbs over weight. I am also post menopause for 3 years. Thank you.

I just stumbled onto this website and am so surprised I haven’t heard about this before. I’ve been doing the primal Blueprint since the summer 2011.
I’d really like to hear what you think about the Biggest Loser!!! That show must just kill you!!

as a mom of a toddler, i’m seeing that snacking is EPIDEMIC in this country. if snacking is an integral part of every preschool and school, is it better to homeschool? your insights really make a good case for homeschooling.

Im continually near tears as I have read through the posts here and your compassionate, information dense responses! I am a 50 year old perimenopausal woman who has suffered from bulimia for the better part of 29 years. At its worst in my 20s and early 30s, I was binging and purging 5-7 times a day. This slowed down in my mid 30s when I had my two kids, but continued sporadically through my 40s. For most of my adulthood, I was 15 to 25 pounds overweight, but my weight increased in my 40s to about 30 to 40 lbs overweight. I am hypothyroid for past several years, on Levothyroxine.

14 months ago, I thought I found the perfect cure and did one round of HCG. Although my Purging was triggered (3-5 times per day), I lost over 20 pounds, I healed my lifelong fear of fats, discovered healthy fats and began eating a loose version of paleo (sugar or baked goods once weekly or more, depending). I did not return to HCG ( which always felt off to me), and in the last year I have regained all but 5 pounds of the weight lost (but you knew that!!).

For the past 7 years, I have worked with an eating disorder/sports med MD who has followed my ridiculously high/low rollercoaster leptin levels and long wanted to put me on Metformin to treat my leptin and insulin resistance. I have always resisted medical treatment, and refused to admit and understand the biological factors of my medical condition–was sure that my condition was emotional and could be healed without meds.

Last week, I returned to my doc, who is passionate about her research on leptin (Dr. Emily Cooper at Seattle Performance Medicine). I have a full barrage of metabolic blood work and glucose testing scheduled for next week, and she is anticipating Metformin treatment. I really get it now that I have a medical condition. I am 5’5″ and now weigh 179 lbs. I stay up until 1 or 2 and wake at 8am, so my sleep patterns do not help. I am not sedentary but do not do cardio more than 1-2 times a week in the form of dance, some yoga, some moderate walking, no weight lifting although I would like to. Needless to say, my body will not lose weight. My base diet is very healthy…green smoothies for breakfast with avocado and coconut milk, chicken salads with olive oil for lunch, animal protein and dark green leafy veggies for dinner. I do not obsesively avoid potatoes or grains, but i only very, very rarely prepare them. I avoid processed foods, but there are times I eat candy and baked goods…last week on vacation I ate 2 pieces of French bread daily, after a year of 90 percent wheat free…so I am not perfect (and don’t aspire to be!!! Just trying to give you an accurate picture). Purging is down to 1-2 times every two weeks for the past four months now.

BTW, my children (10 and 15) are healthy weights, though my daughter, 10, seems to be carb addicted and has very mild asthma, and my son is mildly asthmatic with moderate to severe seasonal allergies. Husband is 25 lbs overweight with worsening asthma. Would love to get them all on a paleo, non dairy diet but no luck with compliance there.

I would love your advice and feedback. I want my ultimate health, a long, active life and a healthy weight already!! thank you so much for everything!!

@Kris thanks for the kind words……Read this ASAP. http://jackkruse.com/primal-cpc-2-eating-disorder-etiology/ After you’re done……you need to go see your local functional medicine doctor and get urinary and salivary neurotransmitter testing done…….people with Eating disorders all have bad leaky guts that lead to horrible brain chemistry issues……all can be solved. The key backbone to the program in my view is a diet loaded with protein in the beginning of the day. It may take a yr to get used to it…….but it is a must. I also mandate probiotics daily for the rest of your life…….but you got to get the neurotransmitter issues worked out stat. That is how the habit is broken eventually……..Eating protein also will help huge in breaking down the ED etiology. You really need to come to my forum and find Momagrok……..she can help you huge and tell you her own story. There is help here to learn how to help yourself……

Jack,
Thanks so much! I’m eager to start reading the forums and taking charge of my health. I have suffered long enough, and it has been such an incredible relief to understand that there are biochemical causes to my ED, and that there is something I can do about it. I will start reading and keep you posted. Thank you for getting it.

Dr. Kruse
I really mangled my question I was not trying to imply reset was to blame as I have only been on a few days but having never really supplemented aggressively before was wondering if that could cause. I will see doc and lab test often and following your advice take responsibility for my health. Thanks

Dr. Kruse, I have hypothyroidism and take Synthroid first thing in the morning. I was instructed not to eat anything for an hour afterwards. I want to participate in your breakfast within 30 minutes of rising but I can’t or can I? Do you have a solution?

I have recently read ‘Mastering Leptin’ by Byron J. Richards. A lot of the info is interesting, though a little confusing. For example, he suggests not eating high fat because this also ‘induces insulin resistance’. He also says you should eat 50:50 protein:carbs (of which wheat, oats etc etc!). Makes me a little unsure about his info…

One thing I have found interesting, however, is that he talks about histamine and neuropeptide Y. He says anti-histamines cause weight gain because ‘brain histamine is synergistic with the action of leptin to depress appetite in the hypothalamus gland of the brain.’ I am a little worried as I was put on antihistamine medication every day for a year (turns out I was misdiagnosed with a histamine allergy). I am 20lbs above my previously normal weight and I am finding it really hard to shift. Could this be to do with antihistamines? Anything I can do about it?

@Helen in my eyes Richards only has part of the story correct and it’s by design. He is looking sell supplements. Anti histamines have a massive effect not only on NPY Y but on your long term risk for Alzheimers disease. Antihistamines reduce the acetyl choline base in the brain and this is precisely what we see in atherosclerosis and AD of the brain

Thanks for your reply. This is extremely interesting. I feel I am in worse state now than before taking them. Foggier thinking, lower energy etc. I guess all I can do is follow low carb paleo diet and do leptin rx to try to get things back to normal? Thanks.

[…] Why is Oprah Still Obese? by Jack Kruse This is one of a series of blog posts where Dr. Kruse lays out the crucial role of master hormone leptin in how the body manages fat stores and hunger signalling. For those with significant fat to lose, I highly recommend his “Leptin reset” protocol also found on his blog. […]

[…] mitochondria are optimal first. This was shown in the leptin series, as well at the muscle level (Oprah post). In my Optimized Life practice, this is one of the first clinical moves I make to light the pilot […]

Hi Jack. Great info by the way! How to manage this lifestyle with slow gastric emptying and nausea silent reflux etc. can i still have a big breakfast and Gaviscon after? Probiotics before bed? What about insulin resistance in adipocytes more than in muscles? Will LR fix this? Can i have a big breakfast and no food till the next day? I do not know how to fix my insulin resistance and gastroparesis after meat meals. Thank you!

Fix your light environment first. Insulin resistance is a blue light toxic issue. Light eneters the eye and can cause many eye diseases you mentioned. IR = blue light toxicity = internet has blue LED screens modern humans use without protection of eyes and skin. The current state of knowledge of the effects of blue light on the regulation of physiologic functions and the possible effects of blue light exposure on ocular health is POORLY known by clinicians, patients, and the health media. Man made has 4 times the blue color temperature of solar blue light and they ARE NOT EQUIVALENT. Man made blue light ruins mitochondrial function in the photoreceptor system DAY and NIGHT because of how they regenerate. These receptors control all the growth and metabolism pathways in the human body. It is time you get the message. Protect your eyes/skin from blue light to avoid neolithic disease. .https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4734149/

Hi jack, wow, fantastic blog. thanks so much! I believe this is my problem. I just turned 51, 35-40 pounds overweight. binge/dieter all my life but no longer on sugary things for a long time – now I do it on healthy food which of course makes it unhealthy! i have very high cortisol in the morning and evening, and I take compounded T3. I did have reverse T3 which I have got rid of by coming off T4 and titrating the T3 up to flush it out following the guidance of a pharamcist. I’m working on my sleep and have all the lights off from 8pm which is making a big difference. 1. I’m wondering can i go for a brisk walk for a hour? I wasn’t clear if that’s considered cardio. 2. Can i go mid morning after my protein for breakfast has been digested? I’m intolerant to eggs. 3. can I have a grass fed whey protein isolate for a change from meat/fish/shellfish that has 1 gram of carb per 50g of protein or would that still create an insulin spike?

I’ve always had poor brain function. I have a functional medicine doctor. 4. is there more I need to know to ask for a urinary and salivary neurotransmitter testing – am I asking for anything specific?

5. I am considering going through IVF using embryos i stored when i was 45 (crazy I know). is it ok to do this diet after the frozen embryo cycle? and fingers crossed during pregnancy?

also my function medicine doctor said if i go to low on the carbs it will stress out my adrenals. not sure what your thoughts are on this? she recommends about 100g per day. happy to try what you think

At 51 with Leptin resistance? That is a Rx for a nightmare. You need to read the Time series where I start talking about mitochondrial heteroplasmy rates. Listen to the podcast I just did this weekend with Adam of Cognitve Rampage on Youtube.

Do you mean just generally that age + LR or doing a frozen embryo cycle at that age with LR? what should i do? I have tried 50g of protein in the morning for about 10 days and I ended up bingeing on carbs as I couldn’t fit in any fat with that because it was too filling.

Loved that podcast and have done lots of reading since. very enlightening!!! I went for a swim in the sea and hung out at the beach walking on the sand this weekend. I’ve forgotten what that’s like. water temp 78 degrees. not cold enough but hopefully it’s doing something – felt good anyway!

I’ve turned the flux down on my computer to 1700, the lowest it will go – probably not enough?

can i brisk walk for an hour?

how much protein should i be having at the other meals? because i have so much at breakfasts I’m wanting to minimise it at other meals but I’m probably not having enough.

Hi Jack,
I’m looking for info on underweight folks. I’m 61yo male, 6ft and been steady around 57kg for 40yrs. I’m physically active laboring on 5 acres. I have always run out of gas quickly and fueled up again on carbs, and carry very little fat. Can you direct me to blogs and info to help me understand this.
Many thanks.

Dr. Kruse,
I’ve been drinking Bulletproof Coffee with Kerry Gold’s Grass Fed Butter then eating a protein healthy breakfast between 11 and 12:00. Can I incorporate the butter coffee with my breakfast first thing? I’m also fascinated by your leptin research. I’d like to follow your protocol although I don’t think I have an issue with leptin. Do you see a problem with that? Thank you for sharing all your expertise!

About Dr. Kruse

Dr. Jack Kruse is a respected neurosurgeon and CEO of Optimized Life, a health and wellness company dedicated to helping patients avoid the healthcare burdens we typically encounter as we age. He is a member of the American Association of Neurological Surgeons, the Congress of Neurologic Surgeons, and Age Management Medicine Group.